Abstract
Emerging evidence strongly suggests that both ambulatory and central blood pressures (BP) are better predictors of future cardiovascular events compared to peripheral office brachial pressures. Early identification of individuals at risk for the development of hypertension would provide the opportunity to target such patients with individualized preventive therapy. Accordingly, the purpose of this study was to investigate predictors (adipokines, insulin sensitivity, and endothelial dysfunction) of higher ambulatory, central, and peripheral blood pressures in a mixed ethnicity cohort of 299 non-hypertensive, young-middle aged adults.
After adjustment for BMI and QUICKI, multiple linear regression showed that both PAI-1 and adiponectin were significantly associated with central SBP (p = 0.034 and 0.045, respectively). PAI-1 also had a significant association with 24-hour DBP and a marginally significant association with central DBP (p = 0.016 and 0.066, respectively). Higher QUICKI (insulin sensitivity measure) was significantly associated with lower peripheral SBP (p = 0.023), as well as lower peripheral and ambulatory DBP. Endothelial dysfunction (lower % FBF increase) was significantly associated with higher peripheral, ambulatory, and central SBP and DBP measures (p < 0.01 for all). In conclusion, the study findings suggest the possible future utility of PAI-1, adiponectin, QUICKI, and endothelial function as early predictors of BP-associated cardiovascular risk in young asymptomatic individuals.