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April 26, 2026Journal of the American College of Cardiology494 citationsOpen Access

Pulse Wave Velocity Is an Independent Predictor of the Longitudinal Increase in Systolic Blood Pressure and of Incident Hypertension in the Baltimore Longitudinal Study of Aging

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SNSamer S. NajjarASAngelo ScuteriVSVeena Shetty

Key Result

Pulse wave velocity was an independent predictor of incident hypertension (HR 1.10 per 1 m/s increase; 95% CI 1.00-1.30; p=0.03) and longitudinal increase in systolic blood pressure.

Key Points

  • The aim is to determine if pulse wave velocity (PWV) predicts changes in systolic blood pressure and incident hypertension over time.
  • Measured PWV at baseline in 449 normotensive or untreated hypertensive volunteers, average age 53 years.
  • Conducted repeated blood pressure measures over an average follow-up of 4.9 years.
  • Analyzed data using linear mixed effects regression and Cox proportional hazards models.
  • PWV was an independent determinant of longitudinal SBP increase (p = 0.003 for interaction with time).
  • In normotensive individuals at baseline, 34% developed hypertension during a median follow-up of 4.3 years.
  • A 1 m/s increase in PWV correlated with a 10% higher risk of developing hypertension (HR 1.10, 95% CI 1.00-1.30, p = 0.03).

Study Design

Type

Cohort (n=449)

Structured PICO

Does baseline pulse wave velocity predict longitudinal increases in systolic blood pressure and incident hypertension in normotensive or untreated hypertensive individuals?

P
Population
449 normotensive or untreated hypertensive volunteers (age 53 +/- 17 years) from the Baltimore Longitudinal Study of Aging
I
Intervention
Baseline pulse wave velocity (PWV) measurement
O
Outcome
Longitudinal increase in systolic blood pressure (SBP) and incident hypertensionsurrogate

Pulse wave velocity independently predicts longitudinal increases in systolic blood pressure and the development of incident hypertension, suggesting its utility in identifying high-risk normotensive individuals.

Main Result

Effect estimate: HR 1.10 (95% CI 1.00-1.30)

p-value: p=0.03

Abstract

OBJECTIVES: This study sought to evaluate whether pulse wave velocity (PWV), a noninvasive index of arterial stiffness, is a predictor of the longitudinal changes in systolic blood pressure (SBP) and of incident hypertension. BACKGROUND: Although arterial stiffness is believed to underlie, in part, the age-associated changes in SBP, particularly at older ages, few longitudinal studies in humans have examined the relationship between arterial stiffness and blood pressure. METHODS: Pulse wave velocity was measured at baseline in 449 normotensive or untreated hypertensive volunteers (age 53 +/- 17 years). Repeated measurements of blood pressure were performed during an average follow-up of 4.9 +/- 2.5 years. RESULTS: After adjusting for covariates including age, body mass index, and mean arterial pressure, linear mixed effects regression models showed that PWV was an independent determinant of the longitudinal increase in SBP (p = 0.003 for the interaction term with time). In a subset of 306 subjects who were normotensive at baseline, hypertension developed in 105 (34%) during a median follow-up of 4.3 years (range 2 to 12 years). By stepwise Cox proportional hazards models, PWV was an independent predictor of incident hypertension (hazard ratio 1.10 per 1 m/s increase in PWV, 95% confidence interval 1.00 to 1.30, p = 0.03) in individuals with a follow-up duration greater than the median. CONCLUSIONS: Pulse wave velocity is an independent predictor of the longitudinal increase in SBP and of incident hypertension. This suggests that PWV could help identify normotensive individuals who should be targeted for the implementation of interventions aimed at preventing or delaying the progression of subclinical arterial stiffening and the onset of hypertension.

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Cite This Study

Najjar et al. (2008) conducted a cohort in Normotension or untreated hypertension (n=449). Pulse wave velocity was evaluated on Incident hypertension (HR 1.10, 95% CI 1.00-1.30, p=0.03). Pulse wave velocity was an independent predictor of incident hypertension (HR 1.10 per 1 m/s increase; 95% CI 1.00-1.30; p=0.03) and longitudinal increase in systolic blood pressure.

synapsesocial.com/papers/69edd8804475e13dead9d581https://doi.org/10.1016/j.jacc.2007.10.065
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