Arterial Stiffness: Good Predictor for Hypertensive Patients

To the Editor: We read the article “Arterial Stiffness as a Predictor of Clinical Hypertension” by Zheng and coworkers with a great interest.1 They investigated the associations among vascular stiffness, blood pressure progression, and hypertension. They concluded that arterial stiffness parameter (ASP) is an independent predictor of blood pressure progression and incident hypertension. We believe that these findings will be guides for further studies on the effect of inflammation in ASPs. ASPs are novel indicators for evaluating endothelial function. Endothelial dysfunction has been shown to be present in patients with hypertension.2 In the present study, the authors showed that higher ASPs are an independent predictor of hypertension. Increased ASPs are common findings of atherosclerotic involvement of the vascular system. However, increased arterial stiffness is an indicator of coronary artery disease, cerebrovascular disease, and peripheral arterial disease.3 There is a growing body of data supporting the association between diabetes and microcirculatory dysfunction. Patients with prediabetes or newly diagnosed diabetes have higher arterial stiffness measurements.4 ASPs may be changed via smoking, hypercholesterolemia, hypothyroidism, and aging. In addition, Behçet's disease is associated with endothelial dysfunction and chronic inflammation. Endothelial dysfunction is commonly investigated by measuring ASPs and were shown to be higher in patients with Behçet's disease compared with a control group.5 We reported that psoriasis was associated with an increased risk of atherosclerosis. ASPs have also been shown to be increased in psoriasis patients compared with controls.6 ASPs have been investigated with respect to their relationship with other studied parameters and have been significantly correlated with albumin and magnesium levels.7 Furthermore, some medications such as antihypertensive agents including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and statins used may influence ASPs.8 ASP is a noninvasive method to assess endothelial dysfunction in clinical practice and may provide useful information to clinicians in hypertension.7 The study would have benefited if these factors were included in the paper. The authors have no conflict of interest to disclose.