Key result
Lifelong elevated BP is linked to higher midlife arterial stiffness, partially mediated by insulin resistance.
Why the study?
Although childhood blood pressure is associated with later arterial stiffness, the contributions of blood pressure across different life stages and the mediating role of metabolic factors remained to be investigated.
Does elevated blood pressure across the life course increase arterial stiffness in midlife?
Cohort (n=1,448)
Does elevated blood pressure across the life course increase arterial stiffness in midlife?
Elevated blood pressure starting in childhood and accumulating through adulthood is associated with increased midlife arterial stiffness, a relationship partially mediated by insulin resistance.
BP control from childhood may reduce midlife stiffness risk; extends life-course evidence but remains hypothesis-generating.
Childhood blood pressure (BP) is associated with increased arterial stiffness later in life. This study aimed to investigate the contributions of BP across different life stages to midlife arterial stiffness and the mediating role of metabolic factors. Using data from the Hanzhong Adolescent Hypertension Study, 1448 participants aged 6-18 years at baseline were prospectively followed for 30 years into adulthood. We used linear regression models to examine the associations between BP at different life stages and brachial-ankle pulse wave velocity (baPWV). In addition, parallel multiple mediation analyses were conducted to evaluate the mediating roles of blood glucose and lipid metabolism in these associations. Significant associations between BP and adult baPWV were observed across childhood, adulthood, and cumulative long-term BP burden, with BP in adulthood showing the strongest association. Additionally, the triglyceride-glucose index was identified as a mediator in the relationship between adult BP and midlife baPWV, with the mediation effects more pronounced among males. Our findings suggest that the detrimental impact of elevated BP on arterial stiffness begins early in life and intensifies over the lifespan, particularly during adulthood. Furthermore, the association between adult BP and arterial stiffness appears to be partially mediated by insulin resistance.
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Wang et al. (2025) conducted a cohort in Arterial stiffness (n=1,448). Blood pressure was evaluated on brachial-ankle pulse wave velocity (baPWV). Elevated blood pressure across childhood and adulthood was significantly associated with increased midlife arterial stiffness over 30 years, partially mediated by insulin resistance.
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