Meili Zheng1, Yong Huo2, Xiaobin Wang3, Xin Xu4, Xianhui Qin4, Genfu Tang5, Houxun Xing5, Fangfang Fan2, Jianping Li2, Yan Zhang2, Binyan Wang4, Xiping Xu4, Xinchun Yang6, Yundai Chen7, Geng Qian7. 1. Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 2. Cardiology Department, Peking University First Hospital, Beijing, China. 3. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 4. National Center for Clinical Research in Kidney Disease, Guangdong Institute of Nephrology, Southern Medical University, Guangzhou, China. 5. Institute of Biomedicine, Anhui Medical University, Hefei, China. 6. Heart Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. Electronic address: yangxc99@gmail.com. 7. Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
Abstract
OBJECTIVES: Recent data indicate that hypertension is not well controlled in many populations throughout the world. The factors that influence individual response to anti-hypertensive treatment need to be clarified. Pulse wave velocity (PWV), as a marker of arterial stiffness, has been demonstrated to have important relationships with BP progression; however, little information is available on the role of PWV in blood pressure (BP) control. We aimed to assess BP control during the run-in treatment period in the China Stroke Primary Prevention Trial (CSPPT). METHODS AND RESULTS: These analyses included a total of 3056 treated hypertensive subjects (age: 59.6±7.5years, male/female 1339/1717) with PWV measured at baseline. The average BP at enrollment was 166/95mmHg, and declined to 141/85mmHg after short-term antihypertensive treatment (a median follow-up of 20days). There was an inverse relationship between PWV level and BP reduction during the treatment, most notably for systolic BP (with estimated coefficients of -9.01 (P<0.001) for the top quartile, as compared to the bottom quartile). The association did not differ significantly by gender or types of antihypertensive drugs. Factors related to smaller BP decline were low baseline BP, high baseline PWV, high body mass index, high creatinine, use of fewer types of antihypertensive drug, high heart rate (only for SBP), high homocysteine and low age (only for DBP). CONCLUSION: PWV appears to be an independent determinant of individual response to anti-hypertensive treatment.
RCT Entities:
OBJECTIVES: Recent data indicate that hypertension is not well controlled in many populations throughout the world. The factors that influence individual response to anti-hypertensive treatment need to be clarified. Pulse wave velocity (PWV), as a marker of arterial stiffness, has been demonstrated to have important relationships with BP progression; however, little information is available on the role of PWV in blood pressure (BP) control. We aimed to assess BP control during the run-in treatment period in the China Stroke Primary Prevention Trial (CSPPT). METHODS AND RESULTS: These analyses included a total of 3056 treated hypertensive subjects (age: 59.6±7.5years, male/female 1339/1717) with PWV measured at baseline. The average BP at enrollment was 166/95mmHg, and declined to 141/85mmHg after short-term antihypertensive treatment (a median follow-up of 20days). There was an inverse relationship between PWV level and BP reduction during the treatment, most notably for systolic BP (with estimated coefficients of -9.01 (P<0.001) for the top quartile, as compared to the bottom quartile). The association did not differ significantly by gender or types of antihypertensive drugs. Factors related to smaller BP decline were low baseline BP, high baseline PWV, high body mass index, high creatinine, use of fewer types of antihypertensive drug, high heart rate (only for SBP), high homocysteine and low age (only for DBP). CONCLUSION: PWV appears to be an independent determinant of individual response to anti-hypertensive treatment.
Authors: Francesco Fantin; Anna Giani; Arianna Franconi; Elena Zoico; Silvia Urbani; Andrea P Rossi; Gloria Mazzali; Mauro Zamboni Journal: Front Cardiovasc Med Date: 2022-06-17