The relationship between pulse pressure index and telomere length in hypertension:A study from the National Health and Nutrition Examination Survey (NHANES)

Background: Telomere shortening is associated with various diseases and several studies have reported that many factors affect telomere length. However, little attention have been paid to the relationship between pulse pressure index (PPI) and telomere length. Therefore, this study aimed to explore the relationship between PPI and telomere length. Methods： A total of 2019 hypertensive patients aged ≥ 18 years participated in the National Health and Nutrition Examination Survey (NHANES, 1999-2002). The participants was divided into two groups according to age: ≤ 45years and > 45years. Stratified analysis, interaction test, multiple regression equations (expressed as β and 95% confidence intervals [CI]) and trend tests, were used to estimate the possible association between PPI and telomere length. Results： We recruited 2019 participants with hypertension and assessed their PPI and telomere length. 415 participants were aged ≤ 45years, 1064 participants were aged > 45 years, and 943 (46.71%) were male. Age is a factor that interacts between PPI and telomere length. We found that a one-unit increase in PPI in hypertensive patients was significantly associated with shorter telomere length (base pair [bp] ) (β =-409.30, 95% confidence interval [CI]:-614.60, -204.00 ), after adjusting for potential confounding factors, including age, sex, body mass index (BMI), race,education, physical activity； smoking; alcohol; diabetes; CKD; take medicine for hypertension. In the age group >45 years , we found that a one-unit increase PPI in hypertensive patients was associated with shorter telomere length (β =-443.73, 95% CI: -664.50, -222.96).Age was the interaction factor between PPI and telomere length. Conclusions ： This study revealed that PPI was negatively associated with telomere length in hypertensive patients, indicating that more attention should be paid to patients with higher PPI in order to prevent cardiovascular events.