Sex modification of the association of the radial augmentation index and incident hypertension in a Chinese community-based population

BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onset of hypertension.This study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at baseline.METHOD A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our analysis.Baseline r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 AI.New-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey.Multivariate regression models were used to evaluate the impact of r AIp75 on the risk of new-onset hypertension.RESULTS After a mean 2.35-year follow-up,213(13.19%)participants developed incident hypertension.No significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive population.Screening of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.