The predictive value of central aortic blood pressure on new onset stroke and differences between brachial blood pressure in a Chinese hypertensive population, a prospective cohort study

Objectives This study aimed to investigate the association between noninvasive central aortic blood pressure and the risk of first stroke in a Chinese community–based population, meanwhile compare the prediction ability of central SBP and peripheral SBP. Methods A total of 8473 Chinese participants without history of stroke and atrial fibrillation at baseline were selected from “Hypertension and Stroke Prevention and Control Project” for analysis. The endpoint of the study was first total stroke and stroke subtypes (ischemic stroke and hemorrhagic stroke). Cox proportional hazards regression, smoothing curve fitting, subgroup analysis, and Kaplan-Meier curve were used to analysis the relationship between central/peripheral systolic blood pressure and first stroke. Results Participants were 60.9±9.6 years old, 63.5% were males, and 96.1% had hypertension. After a mean 3.3-year follow-up, the incidence of first total stroke, first ischemic stroke and first hemorrhagic stroke were 5.1%, 4.6%, and 0.5%, respectively. In multivariate logistic-regression analyses, central and peripheral SBP were both independently associated with first total stroke and first ischemic stroke after adjusting for various confounders. Peripheral SBP's significant association with first total and ischemic stroke disappeared when combined analyzed with central SBP, whereas central SBP was still significantly related with first total and ischemic stroke after adjustment of peripheral SBP. For first hemorrhagic stroke, no significant differences were observed between central SBP and peripheral SBP. Subgroup analysis showed that the central SBP-first stroke association was significantly stronger in males (HR: 1.38; 95% CI: 1.16, 1.63) than in females (HR: 1.10; 95% CI: 0.97, 1.24; P-interaction = 0.028). Conclusions Among the Chinese community–based population, central SBP is a stronger predictor compared with peripheral SBP for first stroke, especially ischemic stroke. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Key R&D Projects, JiangxiOutstanding Person Foundation

Haplotype of receptor for advanced glycation end products is associated with arterial stiffness in essential hypertension

Background What causes us to age has been extensively explored. The receptor for AGEs (RAGE) expression is up-regulated in atherosclerotic plaques and its activation leads to oxidative stress, cytokine and adhesion molecule formation, activation of nuclear factor-κB and cell apoptosis. We hypothesized that genetic variation in the RAGE receptor may be associated with arterial stiffness. Methods 309 untreated hypertensive subjects were tested for genotypes of –374T>A and –429T>C polymorphisms with polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). Arterial stiffness was measured as pulse wave velocity (PWV), augmentation index (AIx) and central aortic blood pressure (BP). Data was analysed using JMP Version 13 (SAS for Windows). Results Both polymorphisms were in Hardy-Weinberg equilibrium. The –374A A allele carriers had significantly lower aortic systolic BP (143±2 vs. 154±1, p<0.001) while –429C allele carriers had lower aortic systolic BP (151±1 vs. 157±2, p<0.01) compared with T carriers. –429C allele carriers had lower PWV compared to 429TT individuals (8.86±1 vs. 10.70±2.5). –374A allele carriers had lower PWV compared to 374TT individuals (9.7±1.43 vs. 10.65±2.6). Subjects with the AC haplotype had the lowest and those with the TT haplotype the highest PWV and aortic BP than any of the other haplotypes containing one or more of the at-risk alleles. Conclusions The combined effect of the two genotypes was additive with AA homozygotes of –374T>A and C allele carriers of –429T>C and the haplotype AC, associated with lowest aortic BP and arterial stiffness. PWV & RAGE haplotypes Funding Acknowledgement Type of funding source: None