The reduction in blood pressure required to reduce arterial stiffness components in SPRINT: a randomized controlled trial.
Theodore M DeConne, Jordan Tanley, Ryan Pewowaruk et al.
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In 30 seconds
This analysis of the multicentre SPRINT randomised controlled trial examined whether blood pressure changes were associated with changes in arterial stiffness components over 1 year. It used supine carotid-femoral pulse wave velocity data from 516 participants and adjusted for baseline covariates. Reductions in systolic, diastolic, and mean arterial pressure were associated with lower total and load-dependent pulse wave velocity, but not structural pulse wave velocity. Participants whose total pulse wave velocity fell by ≥1 m/s had adjusted reductions in systolic, diastolic, and mean arterial pressure that were 11.0, 5.4, and 7.2 mmHg greater, respectively, than those without that reduction.
Key findings
- Reductions in systolic, diastolic, and mean arterial pressure were associated with lower total and load-dependent pulse wave velocity (all P < 0.001), but not structural pulse wave velocity.
- With a total pulse wave velocity reduction of ≥1 m/s, adjusted systolic, diastolic, and mean arterial pressure reductions were 11.0, 5.4, and 7.2 mmHg greater, respectively, than in participants without that reduction.
- The greatest blood pressure reductions across change categories occurred among participants with load-dependent pulse wave velocity decreases of ≥1.0 m/s.
Why it matters
The findings distinguish pressure-dependent changes in arterial stiffness from structural stiffness. In this analysis, blood pressure reduction tracked with improvement in total stiffness through its load-dependent component, while structural stiffness did not change in association with blood pressure reduction. This distinction may help frame how arterial stiffness outcomes are interpreted when evaluating blood pressure interventions.
What to keep in mind
The analysis used a subset of SPRINT participants with pulse wave velocity data and assessed changes over 1 year; the findings do not establish that blood pressure reduction changes structural stiffness over longer periods.