Early Midlife Hypertension Linked to Arterial Stiffness in Women Decades Later: Study

A new study published in the European Journal of Preventive Cardiology showed that high blood pressure in early midlife was associated with increased arterial stiffness 27 years later in women, but not in men.

One of the strongest risk factors for cardiovascular diseases (CVD) in women is hypertension. In a UK biobank research with almost 500,000 people, hypertension raised women's relative risk of myocardial infarction more than it did men's. Similarly, women were nearly twice as likely as males to have an ischemic stroke as a result of worsening hypertension, according to the prospective REGARDS (Reasons for Geographic and Racial Differences in Stroke) research.

According to the Hordaland Health Study, women, but not men, had a twofold chance of developing acute coronary syndromes before the age of 60 if their blood pressure was between 130 and 139/80 and 89 mmHg at age 41. Therefore, using data from the community-based Hordaland Health Study, the current study set out to evaluate sex-specific relationships of these BP categories in early midlife with the occurrence of increased arterial stiffness 27 years later.

A total of 938 men and 1,127 women with a baseline mean age of 42 years had their blood pressure tested. They were classified as having hypertension (≥140/90 mmHg), raised blood pressure (120-139/70-89 mmHg), or non-elevated blood pressure (<120/70 mmHg). A carotid-femoral pulse wave velocity (cf-PWV) greater than 10 m/s was considered to indicate increased arterial stiffness.

After adjusting for baseline body mass index, diabetes, smoking, heart rate, lipids, age, and education, logistic regression analysis was used to evaluate the relationships between baseline blood pressure and increasing arterial stiffness 27 years later. The results were presented as odds ratios (OR) and 95% confidence intervals (CI).

9% of women and 26% of men had hypertension at baseline, whereas 62% of women and 67% of men had raised blood pressure (p<0.001). 31% of men and 17% of women had higher arterial stiffness at follow-up (p<0.001).

According to adjusted analysis, women who had higher baseline blood pressure or hypertension than those who did not had higher arterial stiffness 27 years later (OR 2.78 [95% CI 1.74-4.42] and OR 4.62 [95% CI 2.48-8.58]), but not men (OR 1.10 [95% CI 0.58-2.10] and OR 1.33 [95% CI 0.67-2.66]), with a p-value of 0.01 for sex-interaction.

Overall, in the Hordaland Health Study, women, but not men, had higher arterial stiffness 27 years later if they had high blood pressure or hypertension in their early midlife. These results highlight how crucial early-life blood pressure management is for women's best CVD prevention.

Source:

Kringeland, E., Midtbø, H., Ohldieck, A. E., Aune, A., & Gerdts, E. (2025). Sex-specific associations between blood pressure in early midlife and arterial stiffness 27 years later: The Hordaland Health Study. European Journal of Preventive Cardiology. https://doi.org/10.1093/eurjpc/zwaf379