Vascular ageing manifestations and hypertension in the community

Objective: To investigate the association between joint manifestations of vascular ageing (VA) and hypertension. Methods: We used baseline (2008–2012) and follow-up data (up to 2024) from the Paris Prospective Study III, a French cohort of 10,157 participants. Prevalent and incident hypertension were determined at baseline (blood pressure ≥140/90 mmHg or on medication) and at 2, 4, 6, 8 and 10 years of follow-up (self-reported antihypertensive treatment). VA manifestations were assessed at baseline via echo-tracking in the right common carotid artery. Clustering analysis identified patterns of VA and their association with hypertension was assessed with logistic regression. Results: The cross-sectional analysis included 9,096 participants (mean age: 59±6 years, 39 % female). Hypertension prevalence was 36 % (n = 3,276). Three clusters of VA manifestations were identified. Cluster 1 (n = 4,326;47.6 %) was characterized by healthy vascular ageing (HVA), Cluster 2 by increased arteriosclerosis (ART) (n = 2,274;25.0 %) and Cluster 3 by greater atherosclerosis prevalence (ATH) (n = 2,496;27.4 %). Compared to the HVA cluster, ART (aOR 3.94; 95 % CI 3.50;4.45) and ATH clusters (aOR 2.69; 95 % CI 2.38;3.04) were associated with prevalent hypertension. The prospective analysis included 5,310 normotensives with 754 (14.1 %) cases of incident hypertension (median follow-up of 10.05 years [range: 10.00;10.15]). Both ART (aOR 1.34; 95 % CI 1.08;1.65) and ATH (aOR 1.70; 95 % CI 1.40;2.07) clusters were associated with incident hypertension. Conclusion: Vascular ageing manifestations reflecting increased carotid arteriosclerosis and atherosclerosis are related to prevalent and incident hypertension.