Arterial stiffness and progression to hypertension in Japanese male subjects with high normal blood pressure

Objectives This observational study vias conducted to compare the significance of the relationship between arterial stiffness and progression to higher blood pressure categories among middle-aged Japanese men with high normal blood pressure (HNP), normal blood pressure (NRP) and optimal blood pressure (OPP). Methods and results During the 3-year observational period, 100 subjects with HNP developed hypertension (n = 475; 42 +/- 9 years), and 175 of those with normal NRP (n = 581; 41 +/- 8 years) and 249 of those with OPP (n = 702; 39 8 years) showed progression to higher blood pressure categories. A binary logistic regression analysis adjusted for known risk factors revealed that values of the brachial-ankle pulse wave velocity, a surrogate marker of arterial stiffness, in the highest quartile, as compared with those in the lowest quartile, obtained at the start of the study were significantly predictive of the progression to hypertension adjusted odds ratio = 9.4 (95% confidence interval, 3.0 - 29.8), P < 0.011. The predictive value of this parameter for progression to higher blood pressure categories in subjects With HNP was more significant than that in those with NRP or OPP. Conclusions Increased arterial stiffness and elevated blood pressure may be mutually causally related, and it appears that the significance of this relationship may increase with increasing blood pressure, even in subjects without hypertension. Assessment of arterial stiffness may be more reliable for predicting the progression to hypertension in cases of HNP than in cases with NRP or OPP.