OBJECTIVES Carotid-femoral pulse wave velocity (PWV), an index of arterial stiffness and a proxy of arterial aging, has been reported to be an independent determinant of cardiovascular health. Whether the effects of antihypertensive treatment vary in the presence of accelerated arterial aging (stiffer artery, ie, PWV >10 m/s) has not been established. We tested this hypothesis in a longitudinal study in a large community-dwelling population. DESIGN Longitudinal population study with repeated measures. SETTING AND PARTICIPANTS Study population consisted of a cohort of 6011 volunteers (2546 men and 3465 women, age range 14-101 years; 15,011 observations over a median follow-up of 6.8 years) participating in the SardiNIA Study. MEASURES Repeated measures of PWV, blood pressure (BP), and metabolic risk factors and the antihypertensive medication trajectories of BP and PWV over time were assessed via mixed effects models. RESULTS Antihypertensive treatment significantly affected the trajectory of BP in both participants with (-0.47 ± 0.20 mmHg/y, P = .02) and participants without stiffer arteries (-0.47 ± 0.07 mmHg/y, P = .001). They also affected the trajectory of PWV in participants with stiffer artery, independent of the BP values. CONCLUSIONS AND IMPLICATIONS Antihypertensive treatment is effective in reducing both BP and PWV in older individuals with stiffer arteries.

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更硬的动脉对抗高血压治疗反应的影响：SardiNIA 队列的纵向研究

目的 颈股动脉脉搏波速度 (PWV) 是动脉僵硬度的指标和动脉老化的代表，据报道是心血管健康的独立决定因素。抗高血压治疗的效果是否会随着动脉老化加速（动脉变硬，即 PWV >10 m/s）而变化尚未确定。我们在大型社区居住人口的纵向研究中检验了这一假设。设计 重复测量的纵向人口研究。设置和参与者 研究人群由参与 SardiNIA 研究的 6011 名志愿者（2546 名男性和 3465 名女性，年龄范围 14-101 岁；中位随访 6.8 年中的 15,011 次观察）组成。测量 重复测量 PWV、血压 (BP)、通过混合效应模型评估代谢风险因素以及 BP 和 PWV 随时间推移的抗高血压药物轨迹。结果 抗高血压治疗显着影响了参与者（-0.47 ± 0.20 mmHg/y，P = .02）和没有更硬动脉的参与者（-0.47 ± 0.07 mmHg/y，P = .001）的血压轨迹。它们还影响了动脉硬化参与者的 PWV 轨迹，与血压值无关。结论和意义 抗高血压治疗可有效降低动脉硬化的老年人的血压和 PWV。47 ± 0.07 毫米汞柱/年，P = .001）。它们还影响了动脉硬化参与者的 PWV 轨迹，与血压值无关。结论和意义 抗高血压治疗可有效降低动脉硬化的老年人的血压和 PWV。47 ± 0.07 毫米汞柱/年，P = .001）。它们还影响了动脉硬化参与者的 PWV 轨迹，与血压值无关。结论和意义 抗高血压治疗可有效降低动脉硬化的老年人的血压和 PWV。