Objective: Arterial stiffness and arterial blood pressure (BP) share similar natural history. To which extent the first causes the latter is unknown. Our study describes the development of pulse wave velocity (PWV) and BP in untreated, prehypertensive patients after one year of follow-up.

Patients and methods: Longitudinal study including 427 consecutive, never-treated patients with suspected hypertension. After standard clinical assessment, including PWV (Sphygmocor®, AtcorMedical), 125 showed normal office and ambulatory BP. According to the median baseline PWV, patients were divided into 2 groups: PWV+ and PWV-. After a median of 1.1 years, clinical assessment was repeated. PWV was adjusted to BP.

Results: 76 patients were female (60.8%), mean age was 47 years, baseline office and ambulatory BP were 126/76 and 120/77 mmHg, respectively. The PWV- group were significantly younger (40 vs. 52years, p<001), but systolic, diastolic and mean office BP did not differ compared to the PWV+ group. Only ambulatory SBP was significantly different(118 vs. 121, p<0.03). At follow-up, office systolic and MBP were significantly higher in the PWV+ group (129 vs. 123, p<0.01; 97 vs. 93, p<0.02, respectively), difference in ambulatory SBP remained significant (118 vs. 123; p <0.02). Follow-up PWV did not change in the PWV- group (adjusted PWV 6.9 vs. 7.0; p=ns), whereas PWV significantly improved in the PWV+ group (adjusted PWV 9.1 vs. 8.7; p<0.01).

Conclusions: Measurement of PWV in untreated prehypertensive patients allows to predict development of higher BP values whithin a year, suggesting that arterial stiffness may play a causal role for hypertension.