Longitudinal associations of blood pressure with aortic stiffness and pulsatility: The Atherosclerosis Risk in Communities Study

Patricia A. Metcalf, Michelle L. Meyer, Hirofumi Tanaka, Sunil K. Agarwal, B. Gwen Windham, Susan Cheng, David Couper, Aaron R. Folsom, Gerardo Heiss

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Objective:To characterize the longitudinal relationships between blood pressure measured over 24 years and arterial stiffness in late life measured as pulse wave velocity (PWV).Methods:Carotid-femoral (cf) and femoral- A nkle (fa) PWV were measured in 4166 adults at the visit 5 Atherosclerosis Risk in Communities study cohort examination (2011-2013). Participants were categorized into tertiles of PWV measurements. Blood pressure measurements were made at baseline (1987-1989), three subsequent triennial examinations, and visit 5.Results:Partial correlation coefficients between visit 5 cfPWV and SBP ranged from 0.13 for visit 1 SBP to 0.32 for visit 5 SBP. For visit 5 faPWV, correlations were ∼0 for visits 1 to 4 SBP, but was 0.20 for visit 5 SBP. Over 24 years of follow-up, those with higher average SBP were more likely to fall in the middle and upper tertiles of visit 5 cfPWV. Average pulse pressure and mean arterial pressure over 24 years had similar but weaker associations with cfPWV tertiles. DBP had no clear association with cfPWV. Blood pressure measurements were positively associated with faPWV tertiles only cross-sectionally at visit 5.Conclusion:Adult life-course measures of SBP, more so than mean arterial and pulse pressure, were associated with later life central arterial stiffness. By contrast, only contemporaneous measures of blood pressure were associated with peripheral arterial stiffness. Although arterial stiffness was only measured at later life, these results are consistent with the notion that elevated blood pressure over time is involved in the pathogenesis of arterial stiffening.

Original languageEnglish (US)
Pages (from-to)987-993
Number of pages7
JournalJournal of hypertension
Issue number5
StatePublished - May 1 2021

Bibliographical note

Funding Information:
Sources of support: The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I). The work was supported by R01AG053938. M.L.M. was supported by the UNC BIRCWH K12HD001441.

Publisher Copyright:
© 2021 Authors. All rights reserved.


  • arterial stiffness
  • blood pressure
  • longitudinal study
  • pulse pressure


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