The prevalence and correlates of arterial stiffness in patients with treated hypertension: oscillometric pulse wave analysis during 24-h ambulatory blood pressure monitoring

Abstract

Background: We investigated the prevalence and correlates of arterial stiffness in treated hypertension using oscillometric pulse wave analysis during 24-h ambulatory blood pressure monitoring (ABPM). Methods: In this single-center cross-sectional study, 131 patients (median age 51.0 years, range 17.0–86.0; 54.2% female) underwent 24-h ABPM. Measurements included 24-h, daytime, and night-time SBP, DBP, MAP, pulse pressure, dipping status, and estimated pulse wave velocity (ePWV) derived by the Mobil-O-Graph (ARCSolver; age/SBP-dependent). Results: High ePWV (> 9 m/s) was present in 16.8% of patients. Compared with low/moderate ePWV, the high-ePWV subgroup was older (p < 0.001) and had higher FPG (p < 0.001), higher creatinine and lower eGFR (both p < 0.001), greater proteinuria (p = 0.006), and a lower frequency of systolic dipper status (p = 0.033). In simple correlations, 24-h ePWV was correlated positively with 24-h, daytime, and night-time values of DBP, MAP, and pulse pressure, BMI, FPG, creatinine, uric acid, and proteinuria, and negatively with systolic dipping, diastolic dipping, albumin, and eGFR. However, after adjusting for age, age2, and 24-h SBP, the partial correlation analysis revealed that ePWV was negatively correlated only with FPG (r = −0.216, p = 0.014) and hsCRP (r = −0.220, p = 0.031) and positively correlated only with total cholesterol (r = 0.243, p = 0.043) and LDL (r = 0.359, p = 0.004). Conclusion: Elevated ePWV identifies a high-risk phenotype in treated hypertension, characterized by advanced age and renal impairment. However, these associations appear intrinsic to the algorithm’s reliance on age and SBP. After adjusting for these inputs, ePWV did not exhibit independent associations with clinical parameters, suggesting it should be viewed as an integrated derivative of age and blood pressure rather than a separate physiological measure. ePWV values should be interpreted with caution, recognizing their inherent dependence on algorithmic inputs.