OS 10-05 ASSOCIATION OF AORTIC PULSE WAVE VELOCITY WITH MINERAL METABOLISM FACTORS AND BLOOD PRESSURE IN UNTREATED CHINESE PATIENTS.

OBJECTIVE: Disorders of mineral metabolism predicted incidence of cardiovascular events in various clinical settings, possibly because that arterial stiffness mediate this pathway in part. We investigated the interrelationship between mineral metabolism factors and carotid-femoral PWV, and compared the effect sizes of blood pressure (BP) and mineral factors with carotid-femoral PWV in untreated Chinese.

DESIGN AND METHOD: Consecutive untreated outpatients referred for ambulatory BP monitoring were recruited. Serum parathyroid hormone (PTH) and 25-hydroxyvitamin D were measured with electrochemiluminescence immunoassay, and 24-h urinary calcium and phosphate excretion were determined. Carotid-femoral PWV was measured using the SphygmoCor (AtCor, Australia) device. Pearson's correlation, single and multiple regressions were applied for analyses.

RESULTS: The 1063 participants (mean age 51 years) included 539 (50.7%) women, 658 (61.9%) patients with ambulatory hypertension, 75 (7.1%) patients with arterial stiffness defined as a carotid-femoral PWV ≥ 10 m/s. After standardization for sex, age, body mass index, fasting plasma glucose, serum total and HDL cholesterol, all 24-h BP parameters, including systolic and diastolic BP, mean and pulse pressures, were significantly (r ≥ 0.21, P < 0.001) associated with carotid-femoral PWV, and for mineral metabolism factors, none (P ≥ 0.22) was associated with carotid-femoral PWV, except for serum PTH (r = 0.08, P = 0.008). In fully adjusted model including aforementioned risk factors and both 24-hour systolic BPs and PTH, 24-h BPs (r ≥ 0.21, P < 0.001) and serum PTH (r = 0.06, P = 0.031) remained significantly associated with carotid-femoral PWV. Indeed, per SD (12 mmHg) increment of 24-h systolic BP and each double of serum PTH were associated with the increase in carotid-femoral PWV by 0.45 (0.38-0.52) m/s and by 0.19 (0.049-0.32) m/s, respectively. The effect size associated with 24-hour systolic BP was statistically (P < 0.001) larger than that with PTH.

CONCLUSIONS: Among the studied mineral metabolism factors, only serum PTH, was associated with aortic stiffness, and BP might play a more significant role than PTH in arterial stiffening.