Abstract 14102: The Joint Effect of Arterial Stiffness and High Central Blood Pressure on Risk of Stroke Among Hypertensive Adults

Introduction: The increases in arterial stiffness and central blood pressure (cBP) suggest significant status of vascular damages with different physio-pathological progress. However, the joint effect of them on risk of first stroke have remained uncertain. And the predictive value of CAP over peripheral blood pressure (bBP) is controversial. Hypothesis: This study aims to test the hypothesis that the combination of elevated arterial stiffness and central systolic blood pressure (cSBP) can predict first stroke and is associated with highest risks among hypertensive adults. Methods: A total of 7531 hypertensive adults without prior history of stroke were analyzed. cSBP was measured noninvasively using A-Pulse CASPro device. Arterial stiffness was measured by carotid-femoral pulse wave velocity using the noninvasive PulsePen device (WPP001-ET, DiaTecne s.r.l). Whole data was collected from July 2016 to December 2019. Increased arterial stiffness was defined as cfPWV ≥10 m/s. The primary outcome was first all-cause stroke. Results: Of the 7531 participants, mean age was 61.3 ± 9.3 years, 37.2% were male, the mean brachial blood pressure is the mean cfPWV was 9.4 ± 2.2 m/s, the mean cSBP is 131.3 ± 12.8 mmHg. During a mean follow-up time of 3.3 years, 432 (5.2%) participants developed stroke, of which 380 were ischemic strokes. Compared with the reference group (low cfPWV and cSBP), only the group with both high cfPWV and cSBP was significantly associated with risk of stroke after adjusted for covariates (HR: 1.51, 95% CI 1.10, 2.07). Similar result was found in Kaplan Meier Curve. Such association appears robust in different sub-group analysis. Conclusion: The combination of higher arterial stiffness and central systolic blood pressure is associated with highest risk of first stroke compared to other groups. The combined control of arterial stiffness and central blood pressure serves the purpose of primary prevention of first all-cause stroke among hypertensive population.