Arterial Stiffness and Biochemical Profiles in Prehypertensive, Normotensive, and Controlled Hypertensive Individuals: A Cross-Sectional Study

Jose Fernando Vilela-Martin¹Tatiana Palotta Minari^1,2*MARCO ANTONIO VIEIRA DA SILVA¹Letícia Aparecida Barufi Fernandes¹Marco Aurélio De Almeida¹Valquíria da Silva Lopes¹Kleber Aparecido De Oliveira¹Jessica Rodrigues Roma Uyemura¹Heitor Moreno-Junior³Juan Carlos Yugar-Toledo¹Luciana Neves Cosenso-Martin¹

• ¹Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
• ²Federal University of São Paulo, São Paulo, Brazil
• ³Universidade Estadual de Campinas, Campinas, Brazil

Introduction: Prehypertension predisposes individuals to hypertension as well as increased cardiovascular morbidity and mortality. Additionally, central blood pressure and arterial stiffness indices have been linked to higher cardiovascular mortality rates. This study aimed to compare peripheral and central hemodynamic parameters—including blood pressure, pulse wave velocity, and nocturnal dipping—among normotensive, prehypertensive, and controlled hypertensive individuals, alongside the assessment of biochemical variables. Methods: The study compared clinical and biochemical evaluations and ambulatory blood pressure monitoring (ABPM) results among 47 normotensive (NT), 39 prehypertensive (PH), and 138 controlled hypertensive (CHT) individuals. Peripheral [systolic blood pressure (SBP) and diastolic blood pressure (DBP)] and central hemodynamic [central SBP (cSBP), central DBP (cDBP), and pulse wave velocity (PWV)] parameters were analyzed using ABPM. Central hemodynamic parameters were measured via brachial oscillometry with the Mobil-O-Graph® system. Results: The mean ages of NT, PH, and CHT participants were 48.3 ± 10.6, 50.1 ± 9.6, and 57.7 ± 10.9 years, respectively (P < 0.0001). Compared to NT, PH individuals showed higher 24-hour systolic blood pressure (130.2 ± 5.6 vs. 118.7 ± 4.9 mmHg; P < 0.0001), central systolic pressure (125.4 ± 6.1 vs. 113.2 ± 5.3 mmHg; P < 0.0001), and pulse wave velocity (8.2 ± 1.1 vs. 7.6 ± 0.9 m/s; P = 0.01). Triglycerides levels were significantly higher in PH (178 ± 42 mg/dL) than in NT (132 ± 36 mg/dL; P = 0.0002) and lower than in CHT (192 ± 47 mg/dL; P = 0.03). Glycemia, LDL cholesterol, and total cholesterol also differed significantly between PH and CHT groups (P < 0.001). Conclusion: Prehypertensive individuals exhibited higher peripheral and central blood pressures compared to normotensive individuals but lower levels than controlled hypertensive patients during all three periods (24-hour, wake, and sleep). These findings suggest that functional and structural alterations predisposing individuals to hypertension are already present in the prehypertensive stage.