Is Arterial Stiffness a Determinant of Hypotension?

Introduction: Previous observation identified both hypotension and arterial aging, indexed as Pulse Wave Velocity (PWV), as significant determinants of cognitive decline in older subjects. Aim: To investigate the role of PWV as a determinant of hypotension in older patients. Methods: A cohort of 344 subjects came to our Outpatient Clinic, free of cancer, acute myocardial infarction or stroke, atrial fibrillation, renal, hepatic or cardiac failure, secondary hypertension, or thyroid disease. Results: Hypotension occurred in 49% of participants. SBP levels (OR 0.79, 95% CI 0.67–0.84, p < 0.01), PWV (OR 0.86, 95% CI 0.77–0.94, p < 0.01), and use of beta-blockers (OR 2.42, 95% CI 1.09–5.36, p < 0.05), were independent determinants of the risk of hypotension. Conclusions: Hypotension is a quite common phenomenon in older subjects. Its prevention requires a more accurate management of hypertension aimed at better identifying which older subjects in whom intensive BP control may be harmful and those who may benefit from it.