Relationship between pulse wave velocity progression and baseline heart rate and its change over 3.7 years of follow-up in hypertensive patients

Objective: The role of resting heart rate (HR) and of its changes over time on the progression of pulse wave velocity (PWV) has not been extensively evaluated. The aim of this study was to investigate this relationship in a population of hypertensive patients in a longitudinal study. Methods: We enrolled 572 hypertensive outpatients aged 18-80, followed by the Hypertension Unit of St. Gerardo Hospital (Monza, Italy). Anamnestic, clinical and laboratory data, BP and PWV were assessed at baseline and after a median follow-up of 3.7±0.5years. Results: At baseline, mean age was 53.9±12.7years, SBP and DBP were 141.2±17.8 and 86.5±10.5mmHg, HR was 65.6±10.9bpm and PWV was 8.6±2.0m/s. Despite an improvement in BP and therapies, at follow-up, a PWV increase (ΔPWV 0.5±2.2m/s). In patients with higher ΔHR, ΔPWV was significantly higher (0.82±2.22 vs. 0.27±2.25m/s, P=0.003). At multivariable stepwise regression, baseline HR showed a significant association with baseline PWV. However, neither HR nor ΔHR was significantly associated with ΔPWV. Same results were confirmed by mediation analysis. Conclusion: The main result of our study was that despite the presence of a significant association between baseline HR and baseline PWV, neither HR nor ΔHR was significantly associated with PWV progression (ΔPWV). On the contrary, baseline PWV and baseline BP (SBP, DBP, MBP and PP) and their changes during follow-up present significant association with an accelerated process of arterial stiffening.