Abstract P171: Association Between Blood Pressure Control and Ten-Year Progression in Carotid Arterial Stiffness Varied by Diabetes Status Among Treated Hypertensive Individuals: The Multi-Ethnic Study of Atherosclerosis
Introduction: The association between hypertension and arterial stiffness was shown to be stronger among diabetic patients. However, it is not known whether the association between controlled blood pressure (BP) and arterial stiffness progression varies by diabetes mellitus status.
Methods: We used data from the Multi-Ethnic Study of Atherosclerosis among 879 individuals who were hypertensive and treated at baseline and three follow-up visits (mean age 63.7 years, 44% males at baseline). Carotid arterial stiffness was measured using distensibility coefficient (DC) and Young’s elastic modulus (YEM) at baseline and after a mean of 9.5 years (exam 5). Participants were considered as having controlled BP if their systolic and diastolic BP were <140/90 mmHg. In separate multiple linear regression models, changes in DC and YEM between exams 1 and 5 were regressed on categories of number of visits with controlled BP across visits 1-4. Additional analysis was made stratifying by diabetes status.
Results: Mean DC and YEM were 2.8x10-3 mmHg-1 and 3.6x103 mmHg at baseline and 2.6x10-3 mmHg-1 and 4.2x103 mmHg at exam 5, respectively. After adjusting for potential confounders, ten-year progression in arterial stiffness was significantly lower among individuals with controlled BP at three or four visits as compared to those with controlled BP at only one or no visit. There was borderline significant interaction between number of visits with controlled BP and diabetes (P=0.06). When stratified by diabetes, the association was significant only among non-diabetic participants. There was significant trend in the progression of arterial stiffness by the number of visits with control BP (Table 1).
Conclusion: Long-term control of BP among treated hypertensive individuals was significantly associated with lower ten-year progression in arterial stiffness only among non-diabetic individuals. Controlling BP alone may not be enough to slow progression of arterial stiffness among diabetic individuals.
Author Disclosures: Y.G. Tedla: None. A. Gepner: None. L. Colangelo: None. J. Stein: None. K. Liu: None. P. Greenland: None.
- © 2016 by American Heart Association, Inc.