Vascular stiffness, instead of coronary artery calcification, exhibits significant association with hypertension risk in general population

Hypertension (HTN) significantly increases cardiovascular risk worldwide, and its incidence is expected to rise further over time. Both coronary artery calcification (CAC) and vascular stiffness (VS) potentially contribute to hypertension, but whether CAC and VS jointly aggravates the risk of hypertension remains under-explored. We retrospectively assembled a cohort of individuals with low cardiovascular risk. Coronary computed tomography and pulse wave velocity test were used to measure CAC and VS, respectively. Subsequently, we conducted multiple logistic regression to investigate risk factors for having hypertension, incorporating CAC or VS statuses adjusting for demographics, anthropometric indices, laboratory and echocardiographic parameters. Totally 321 community-dwelling individuals (55 ± 11 years; 73.21 % male) were included. Unadjusted analyses showed that participants with CAC (odds ratio (OR) 2.331, 95% confidence interval (CI) 1.41-3.84) or VS (OR 15.701, 95% CI 4.77-51.58) had significantly higher hypertension risk, whereas multivariate adjustment negated the relationship between CAC and hypertension (OR 1.149, 95% CI 0.55-2.38) but not that between VS and hypertension (OR 12.950, 95% CI 2.87-58.31). Analyses incorporating CAC and VS simultaneously showed that only VS independently correlated with hypertension risk but not CAC. VS plays a more important role in affecting hypertension risk compared to CAC in general population. We suggest that targeting VS would be a more appropriate strategy for mitigating incident hypertension compared to treating CAC.