Open Access
Issue
Published:
28 January 2021
Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population
Download citation
536
Views
21
Downloads
0
Crossref
0
WoS
0
Scopus
1
CSCD
Arterial stiffness, as assessed by aortic ultrasound and pulse wave velocity, is associated with incident hypertension. However, there is still no consensus on whether the augmentation index (AI) affects new onset of hypertension. This study investigated the relationship of radial AI (rAI) and incident hypertension in a Chinese community-based population without hypertension at baseline.
A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing, China were included in our analysis. Baseline rAI normalized to heart rate of 75 beats/min (rAIp75) was obtained using HEM-9000AI. New-onset hypertension was defined as blood pressure ≥ 140/90 mmHg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey. Multivariate regression models were used to evaluate the impact of rAIp75 on the risk of new-onset hypertension.
After a mean 2.35-year follow-up, 213 (13.19%) participants developed incident hypertension. No significant relation between rAIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders (adjusted odds ratio (OR) and 95% confidence interval (CI): 1.09 [0.95−1.27]; P = 0.2260). However, rAIp75 was significantly associated with incident hypertension in women, but not in men (adjusted OR and 95% CI: 1.29 [1.06−1.56], P = 0.0113 for women; 0.91 [0.72−1.15], P = 0.4244 for men; P for interaction = 0.0133).
Sex modified the effect of the rAI on incident hypertension in a Chinese, community-based, non-hypertensive population. Screening of the rAI could be considered in women with a high risk of hypertension for the purpose of primary intervention.
menu
Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population
Abstract
Arterial stiffness, as assessed by aortic ultrasound and pulse wave velocity, is associated with incident hypertension. However, there is still no consensus on whether the augmentation index (AI) affects new onset of hypertension. This study investigated the relationship of radial AI (rAI) and incident hypertension in a Chinese community-based population without hypertension at baseline.
A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing, China were included in our analysis. Baseline rAI normalized to heart rate of 75 beats/min (rAIp75) was obtained using HEM-9000AI. New-onset hypertension was defined as blood pressure ≥ 140/90 mmHg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey. Multivariate regression models were used to evaluate the impact of rAIp75 on the risk of new-onset hypertension.
After a mean 2.35-year follow-up, 213 (13.19%) participants developed incident hypertension. No significant relation between rAIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders (adjusted odds ratio (OR) and 95% confidence interval (CI): 1.09 [0.95−1.27]; P = 0.2260). However, rAIp75 was significantly associated with incident hypertension in women, but not in men (adjusted OR and 95% CI: 1.29 [1.06−1.56], P = 0.0113 for women; 0.91 [0.72−1.15], P = 0.4244 for men; P for interaction = 0.0133).
Sex modified the effect of the rAI on incident hypertension in a Chinese, community-based, non-hypertensive population. Screening of the rAI could be considered in women with a high risk of hypertension for the purpose of primary intervention.
References(39)
Wang Z, Chen Z, Zhang L, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015. Circulation 2018; 137: 2344−2356.
Kaess BM, Rong J, Larson MG, et al. Aortic stiffness, blood pressure progression, and incident hypertension. JAMA 2012; 308: 875−881.
Najjar SS, Scuteri A, Shetty V, et al. 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. J Am Coll Cardiol 2008; 51: 1377−1383.
Liao D, Arnett DK, Tyroler HA, et al. Arterial stiffness and the development of hypertension. The ARIC study. Hypertension 1999; 34: 201−206.
Dernellis J, Panaretou M. Aortic stiffness is an independent predictor of progression to hypertension in nonhypertensive subjects. Hypertension 2005; 45: 426−431.
Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003; 107: 2864−2869.
O'Rourke MF, Hashimoto J. Mechanical factors in arterial aging: a clinical perspective. J Am Coll Cardiol 2007; 50: 1−13.
Tomiyama H, O'Rourke MF, Hashimoto H, et al. Central blood pressure: a powerful predictor of the development of hypertension. Hypertens Res 2013; 36: 19−24.
Tomiyama H, Townsend RR, Matsumoto C, et al. Arterial stiffness/central hemodynamics, renal function, and development of hypertension over the short term. J Hypertens 2014; 32: 90−99.
Tomiyama H, Komatsu S, Shiina K, et al. Effect of wave reflection and arterial stiffness on the risk of development of hypertension in Japanese men. J Am Heart Assoc 2018; 7: e008175.
Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E, et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J 2016; 37: 24−34.
Shufelt CL, Pacheco C, Tweet MS, et al. Sex-Specific Physiology and Cardiovascular Disease. Adv Exp Med Biol 2018; 1065: 433−454.
Singh M, Mensah GA, Bakris G. Pathogenesis and clinical physiology of hypertension. Cardiol Clin 2010; 28: 545−559.
Mitchell GF. Arterial stiffness and hypertension. Hypertension 2014; 64: 13−18.
Le VP, Knutsen RH, Mecham RP, et al. Decreased aortic diameter and compliance precedes blood pressure increases in postnatal development of elastin-insufficient mice. Am J Physiol Heart Circ Physiol 2011; 301: H221−H229.
Salaymeh KJ, Banerjee A. Evaluation of arterial stiffness in children with Williams syndrome: Does it play a role in evolving hypertension? Am Heart J 2001; 142: 549−555.
Zheng X, Jin C, Liu Y, et al. Arterial stiffness as a predictor of clinical hypertension. J Clin Hypertens (Greenwich) 2015; 17: 582−591.
Benetos A, Adamopoulos C, Bureau J, et al. Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period. Circulation 2002; 105: 1202−1207.
Yambe M, Tomiyama H, Yamada J, et al. Arterial stiffness and progression to hypertension in Japanese male subjects with high normal blood pressure. J Hypertens 2007; 25: 87−93.
Koivistoinen T, Lyytikainen LP, Aatola H, et al. Pulse wave velocity predicts the progression of blood pressure and development of hypertension in young adults. Hypertension 2018; 71: 451−456.
Ji H, Kim A, Ebinger JE, et al. Sex differences in blood pressure trajectories over the life course. JAMA Cardiol 2020; 5: 19−26.
Ogola BO, Zimmerman MA, Clark GL, et al. New insights into arterial stiffening: does sex matter? Am J Physiol Heart Circ Physiol 2018; 315: H1073−H1087.
DuPont JJ, Kenney RM, Patel AR, et al. Sex differences in mechanisms of arterial stiffness. Brit J Pharmacol 2019; 176: 4208−4225.
Scuteri A, Morrell CH, Orrù M, et al. Longitudinal perspective on the conundrum of central arterial stiffness, blood pressure, and aging. Hypertension 2014; 64: 1219−1227.
Shimizu M, Kario K. Role of the augmentation index in hypertension. Ther Adv Cardiovasc Dis 2008; 2: 25−35.
Chirinos JA, Zambrano JP, Chakko S, et al. Aortic pressure augmentation predicts adverse cardiovascular events in patients with established coronary artery disease. Hypertension 2005; 45: 980−985.
Weber T, Auer J, O'Rourke MF, et al. Increased arterial wave reflections predict severe cardiovascular events in patients undergoing percutaneous coronary interventions. Eur Heart J 2005; 26: 2657−2663.
Chen CH, Ting CT, Nussbacher A, et al. Validation of carotid artery tonometry as a means of estimating augmentation index of ascending aortic pressure. Hypertension 1996; 27: 168−175.
Sugawara J, Komine H, Hayashi K, et al. Relationship between augmentation index obtained from carotid and radial artery pressure waveforms. J Hypertens 2007; 25: 375−381.
Melenovsky V, Borlaug BA, Fetics B, et al. Estimation of central pressure augmentation using automated radial artery tonometry. J Hypertens 2007; 25: 1403−1409.
Sugawara J, Komine H, Yoshiwaza M, et al. Racial differences in relation between carotid and radial Augmentation Index. Artery Res 2010; 4: 15−18.
Segers P, Rietzschel E, Heireman S, et al. Carotid tonometry versus synthesized aorta pressure waves for the estimation of central systolic blood pressure and augmentation index. Am J Hypertens 2005; 18: 1168−1173.
Kohara K, Tabara Y, Oshiumi A, et al. Radial augmentation index: a useful and easily obtainable parameter for vascular aging. Am J Hypertens 2005; 18(1 Pt 2): 11S−14S.
Millasseau SC, Patel SJ, Redwood SR, et al. Pressure wave reflection assessed from the peripheral pulse: is a transfer function necessary? Hypertension 2003; 41: 1016−1020.
Zahner GJ, Gruendl MA, Spaulding KA, et al. Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry. J Vasc Surg 2017; 66: 1518−1526.
Rosenbaum D, Giral P, Chapman J, et al. Radial augmentation index is a surrogate marker of atherosclerotic burden in a primary prevention cohort. Atherosclerosis 2013; 231: 436−441.
Xiao WK, Ye P, Luo LM, et al. [Radial augmentation index is associated with cardiovascular risk and arterial stiffness]. Zhonghua Nei Ke Za Zhi 2011; 50: 831−835 [In Chinese].
Takenaka T, Mimura T, Kanno Y, et al. Qualification of arterial stiffness as a risk factor to the progression of chronic kidney diseases. Am J Nephrol 2005; 25: 417−424.
FEEDBACK 
TOP