Association between isolated diastolic hypertension and cardiovascular events: a systematic review and meta-analysis of prospective cohorts

Background

Isolated diastolic hypertension (IDH) is a subtype of hypertension, which is defined as systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) ≥90 mmHg by 2018 European Society of Cardiology (ESC) guideline and 2019 National Institute for Health and Care Excellent (NICE). Whereas some previous studies have demonstrated the significant association between IDH and cardiovascular (CV) events, some have not.

Purpose

To assess the association between IDH and the risk of CV events, CV mortality, and all-cause mortality.

Methods

We conducted a systematic search for publications using Medline, Embase, and the Cochrane Library from inception through March 2021 for prospective cohort studies exploring the association between IDH and CV events, CV mortality, and all-cause mortality. Relative risks (RR) or hazard ratios were extracted from the selected studies. Random effect models with inverse variance weighting were used to calculate the pooled RR and 95% confidence interval (CI). The primary outcome was a composite of total CV events including CV mortality. The secondary outcomes were CV mortality and all-cause mortality. We defined the IDH as SBP <140 mmHg and DBP ≥90 mmHg, reference group as BP less than 140/90mmHg.

Results

Overall, 15 studies were identified including 1049587 participants (5.5% IDH). For the primary outcome, IDH was significantly associated with risk of CV events (RR, 1.40 [95% CI, 1.18–1.66], p<0.001). The increased risk of CV events was also observed in subgroup analyses based on age (less or more than 50) and sex. However, in further stratified analysis based on geographical region, only the Asia population showed a significant association with increased risk of CV events, whereas results were null in Europe and North America populations. For the secondary outcomes, IDH was significantly associated with increased CV mortality (RR [95% CI], 1.41 [1.12–1.78], p<0.001) but not with all-cause mortality (RR [95% CI], 1.13 [0.86–1.48], p=0.378). The sensitivity analysis showed the overall results did not vary significantly after exclusion of any one study.

Conclusions

IDH is associated with increased risk of CV events and CV mortality. Further, more large-scale prospective epidemiological cohorts are needed to confirm our conclusion.

Funding Acknowledgement

Type of funding sources: None. Primary outcomeSecondary outcomes

[Quotations from The List of Medical Doctors (Ming Yi Lu) in The Medical Theory (Yi Shuo) and The Mengqiu of Famous Medical Doctors in the Previous Dynasties (Li Dai Ming Yi Meng Qiu)]

The Medical Theory (Yi Shuo) and The Mengqiu of Famous Medical Doctors in the Past Dynasties (Li Dai Ming Yi Meng Qiu) are two medical books that originated in the Song Dynasty. The two books quoted from The List of Medical Doctors (Ming Yi Lu) many times while the author and the issue time of The List of Medical Doctors (Ming Yi Lu) has not been clearly known up to know. It was found that there were 25 quotations in The Medical Theory (Yi Shuo) and 31 quotations in The Mengqiu of Famous Medical Doctors in the Past Dynasties (Li Dai Ming Yi Meng Qiu) from The List of Medical Doctors (Ming Yi Lu). The contents quoted in the two books are also found in The Mysterious Medical List (Shen Mi Ming Yi Lu) written by Dang Yongnian in the Song Dynasty. In this sense, it can be inferred that The List of Medical Doctors (Ming Yi Lu) mentioned above should be The Mysterious Medical List (Shen Mi Ming Yi Lu).

Comparing the bone mineral density among male patients with latent autoimmune diabetes and classical type 1 and type 2 diabetes, and exploring risk factors for osteoporosis

AIMS

This study aimed to compare the bone mineral densities (BMDs) among male patients with latent autoimmune diabetes in adults (LADA), classical type 1 diabetes (T1DM), and type 2 diabetes (T2DM), and to examine the risk factors for developing low BMD in these patients.

PATIENTS AND METHODS

Between January 2017 and October 2020, a total of 57, 67, and 223 male patients with LADA, classical T1DM, and T2DM, respectively, were recruited from the endocrinology department of Shanghai Tenth People's Hospital. Hormonal markers of bone metabolism, lipid profiles, uric acid, glycosylated hemoglobin A1c (HbA1c), and beta-cell function were measured using blood samples. BMD was measured at the lumbar spine, femoral neck, and right hip by dual-energy X-ray absorptiometry.

RESULTS

The mean BMD values from all three skeletal sites in male patients with LADA were comparable to those with classical T1DM but were much lower than those with T2DM. After adjusting for confounding factors, multiple linear regression analysis demonstrated that in all male patients with diabetes, body mass index (BMI), uric acid, and fasting C-peptide showed significant positive associations with BMD at all three skeletal sites; however, osteocalcin showed a negative association at all three sites.

CONCLUSIONS

Compared with male patients with T2DM, lower BMDs were observed in patients with LADA and T1DM. Low BMI, uric acid, C-peptide levels, and high osteocalcin levels are risk factors for developing low BMD in male patients with diabetes.

A three-dimensional finite difference model for ocean acoustic propagation and benchmarking for topographic effects

A three-dimensional (3D) finite difference (FD) model with formal fourth-order accuracy has been developed for the ocean acoustic Helmholtz equation (HE), which can be used to address arbitrary bathymetry and provide more accurate benchmark solutions for other 3D underwater acoustic approximate models. The derivatives in the acoustic HE are numerically discretized based on regular grids, and the perfectly matched layer is introduced to absorb unphysical reflections from the boundaries where Sommerfeld radiation conditions are deployed. The system of linear equations is solved using a parallel matrix-free geometric multigrid preconditioned biconjugate gradient stabilized iteration method, and the code (named COACH) is run on the Tianhe-2 supercomputer in China. Four 3D topographic benchmark acoustic cases-a wedge waveguide, Gaussian canyon, conical seamount, and corrugated seabed-are simulated to test the present FD model, and the maximum number of grid points reaches 33.15 × 10⁹ in the wedge waveguide case, running in parallel with 988 central processing unit cores. Furthermore, the accuracy and generality of the present model have been verified by solution comparisons with other available 3D acoustic propagation models, and the two-dimensional and 3D transmission loss contours are presented to facilitate the distinguishing among the acoustic field features of these cases.

SGN nerve filaments develop synapses with IHCs earlier than with OHCs in C57BL/6 mouse inner ear

OBJECTIVE

To explore the connections between hair cells and spiral ganglion neurons (SGNs) during the development of the C57BL/6 mouse inner ear.

MATERIALS AND METHODS

The specimens of C57BL/6 mouse inner ear, from E15 (embryo day 15) to adult mouse, were collected; immunohistochemistry was employed to explore the frozen sections of specimens.

RESULTS

The development of cochlea starts sequentially from the basal turn to the apex turn. Morphological development of SGNs occurs mainly from E16 to P12 (postnatal day 12). Hair cells appear from E18 to P12, and inner hair cells (IHCs) develop earlier than outer hair cells (OHCs). The connections between hair cells and SGNs begin to develop during E18-P1, morphologically resemble mature synapses during P8-P12, and completely mature in adult mice.

CONCLUSIONS

The genesis of auditory ribbon synapse occurs from E18 to P1. Synchronized with the development of SGNs and hair cells, the functional filaments remain connected to hair cells, while the spare ones get disconnected from the surface of hair cells. Connections between SGN nerve filaments and IHCs occur earlier than those between SGN nerve filaments and OHCs.

[Clinical efficacy and safety analysis of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma: a multicenter retrospective study]

Objective: To analyze the clinical efficacy and safety of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma (HCC). Methods: Ninety-four cases with mid-and advanced-stage HCC who received camrelizumab combined with apatinib as second-line treatment were enrolled. Routine blood test, blood biochemical indexes, tumor stage, tumor imaging characteristics, previous treatment strategies and other clinical data before treatment were documented. Imaging examination follow-up results and adverse reactions during treatment were followed up until the end of follow-up or loss of follow-up or death. Kaplan-Meier method was used to analyze the clinical efficacy. Results: As of the last follow-up, 94 cases with mid-and advanced-stage HCC had received camrelizumab combined with apatinib as second-line treatment. Among them, 15 cases were lost to follow-up, 31 cases died, and 48 cases survived. The overall remission rate was 31.9%. The overall disease control rate was 71.3%. The median time to disease-free progression was 6.6 months. The median time to disease progression was not yet available. The 1-year cumulative survival rate was 62.3%. Grade 3 and above adverse reactions mainly included were thrombocytopenia (7.4%), abdominal pain (4.3%), active hepatitis (4.3%), leukopenia (4.3%), diarrhea (3.2%), hand-foot syndrome (3.2%). All adverse reactions were effectively controlled. Conclusion: Camrelizumab combined with apatinib can effectively prolong the survival period of patients with mid-and advanced-stage HCC, and it is well tolerated.

Doppler-based predictive model for methotrexate resistance in low-risk gestational trophoblastic neoplasia with myometrial invasion: prospective study of 147 patients

OBJECTIVES

This prospective clinical study aimed to evaluate the vascularization characteristics of low-risk gestational trophoblastic neoplasia (GTN) using Doppler imaging and to develop a predictive model for resistance to methotrexate (MTX).

METHODS

Patients with low-risk GTN receiving primary MTX treatment were enrolled from the Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China, from September 2012 to August 2018. The primary endpoint was to develop and internally validate a predictive model for resistance to MTX therapy in these patients. In the training set, clinical features and Doppler hemodynamic parameters before MTX therapy were analyzed using logistic regression to identify independent predictors of MTX resistance, which were integrated into the model. The predictive performance of the model was evaluated by leave-one-out cross-validation in the training dataset and internal validation in an independent-sample test dataset.

RESULTS

The entire imaging protocol was completed by 147 eligible patients, of which 110 comprised the training set and 37 the test set. In the training set, cases with myometrial invasion (81.8%; 90/110) showed vascular-enriched areas in the myometrium and high velocity and low impedance ratios of the uterine artery (UtA) compared to cases without myometrial invasion (18.2%; 20/110). On multivariate logistic regression analysis, time-averaged mean velocity in UtA (UtA-TAmean) and the International Federation of Gynecology and Obstetrics (FIGO) score were identified as independent predictors (P = 0.009 and P = 0.043, respectively) of MTX resistance. The Doppler-based predictive model, developed based on the 90 cases with myometrial invasion, was y = -2.95332 + 0.41696 × FIGO score + 0.03551 × UtA-TAmean. The model showed an area under the curve of 0.757 (95% CI, 0.653-0.862) and the optimal cut-off value was 0.50622, which had 45.2% sensitivity and 96.6% specificity. The model stratified patients with low-risk GTN into low (< 10%), intermediate (10-90%) and high (> 90%) probability of MTX resistance, based on the threshold values of -1.59544 and 0.10046. The model had an accuracy of 74.4% (95% CI, 64.5-82.3%) in the cross-validation and 72.7% (95% CI, 55.8-84.9%) in the internal validation.

CONCLUSIONS

The Doppler-based predictive model, combining a non-invasive marker of tumor vascularity with the FIGO scoring system, can differentiate cases with low from those with high probability of developing MTX resistance and therefore has the potential to guide treatment options in patients with low-risk GTN and myometrial invasion. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

A uniportal right upper lobectomy by three-arm robotic-assisted thoracoscopic surgery using the da Vinci (Xi) Surgical System in the treatment of early-stage lung cancer

Minimally invasive techniques, typified by video-assisted thoracoscopic surgery, are widely practiced in the treatment of thoracic diseases all around the world, and video-assisted thoracoscopic surgery has been recognized as a standard treatment method for early staged lung cancer. Among them, robotic-assisted thoracoscopic surgery, which has the advantages of providing a three-dimensional view and better maneuverability, has emerged as a next-generation technique in the field of minimally invasive surgery and is also gaining its popularity with the idea of Enhanced Recovery After Surgery deeply rooted in patients' minds. Up to now, robotic-assisted thoracoscopic surgery usually requires 3 or 4 ports with 1 or 2 additional access incisions. Meanwhile, traditional video-assisted thoracoscopic surgery can now be completed with uniportal method, with less postoperative pain and higher patient satisfaction with respect to the number of incisions in comparison with the multi-port technique. To inform the integration of these new minimally invasive techniques, here, we present a case in which uniportal right upper lobectomy was performed using the 4^th generation da Vinci Robotic Surgical System (Xi). With continuous innovation in robotic minimally invasive techniques and improvements in surgical skills, we believe more patients will benefit from robotic-assisted thoracoscopic surgery with single port in the near future.

Summary of 3rd Sino-German symposium on fundamentals of advanced nuclear safety technology

The 3rd "Sino-German Symposium on Fundamentals of Advanced Nuclear Safety Technology (SG-FANS)" took place in Xi’an, China, in 2019. Common fields of interests have been identified on both Chinese and German side, such as code benchmarking, common access to experimental facilities and joint experimental data base for nuclear safety analyses.

Remote monitoring of patient recovery following lung cancer surgery: a messenger application approach

Background

Repeated assessment of patient recovery after discharge is challenging. This study used a popular messenger application to remotely collect patient self-reported symptoms and their severity so as to monitor patient recovery and identify the factors affecting the recovery of symptoms following lung cancer surgery.

Methods

This prospective observational study was conducted at a single tertiary lung cancer center in China between November 2018 and June 2019. Participants received demonstration videos and repeated symptom surveys regarding pain and cough severity (assessed using numeric rating scores of 0–10 for pain and 0–6 for cough) at 2, 4, 6, 8, and 12 weeks after discharge via a smartphone program bound to the WeChat application. Patients who responded to at least 3 of the 5 post-discharge surveys were included in this study. The data were analyzed to investigate the symptom recovery and its related factors.

Results

Of the 826 patients enrolled, 589 (71.3%) responded to at least three surveys. The average pain score reduced from 4.1±2.5 at 2 weeks to 2.2±2.0 at 12 weeks (P<0.001). Factors associated with higher pain severity included the female gender, age over 60 years, thoracotomy, longer operation time (>90 minutes), and prolonged chest tube drainage (>7 days). The average cough score decreased from 2.34±1.30 at 2 weeks to 1.93±1.26 at 12 weeks (P<0.001). Being female and a prolonged operation time (>90 min) were related to increased cough severity. Sublobar resection and limited lymphadenectomy may contribute to lower cough severity post-surgery.

Conclusions

The messenger application-based remote monitoring successfully collected post-discharge symptom information and identified factors associated with recovery following lung surgery.

[The relationship between resting heart rate and all-cause mortality among the Chinese oldest-old aged more than 80: a prospective cohort study]

Objective: To explore the association between resting heart rate(RHR) and all-cause mortality among the Chinese oldest-old aged more than 80. Methods: Using a total of seven surveys or follow-ups data (1998, 2000, 2002, 2005, 2008, 2011 and 2014) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 17 886 elderly over 80 years old were selected as subjects, their resting heart rate were measured though baseline survey and the survival outcome and death time of the subjects were followed up. The subjects were divided into 6 groups according to their resting heart rate. Cox regression model was used to estimate the effect of resting heart rate on mortality risk. The interaction of age, gender and resting heart rate was also analyzed by likelihood ratio test. Results: The age of subjects M (P₂₅, P₇₅) was 92 (86, 100) years old, including 10 531 females (58.9%) and there were 13 598 participants died, the mortality rate was 195.5 per 1 000 person-years. Multivariate Cox regression analysis showed that compared to the control group (60-69 pbm/min), the hazard ratio of the elderly are 1.06 (95%CI: 1.02, 1.11), 1.09 (95%CI: 1.04, 1.15), 1.23 (95%CI: 1.14, 1.34), 1.25 (95%CI: 1.08, 1.44) in the group of RHR between 70-79, 80-89, 90-99 and ≥100 pbm/min and P values are all less than 0.05. Likelihood ratio test showed that RHR and age had an interaction effect. (P for interaction=0.011). Conclusion: The risk of all-cause death increased with the increase of resting heart rate and this relationship was stronger between the 80-89 years old people.

BMI modifies the association between serum HDL cholesterol and stroke in a hypertensive population without atrial fibrillation

PURPOSE

Both high-density lipoprotein cholesterol (HDL-C) and body mass index (BMI) have an impact on the prevalence of stroke. However, it is unclear whether BMI can modify the relationship between HDL-C and stroke. Therefore, we aimed to assess the effect of the BMI on the association between HDL-C and stroke in a hypertensive population without atrial fibrillation (AF).

METHODS

We analyzed data of 10,925 hypertensive patients without AF from the Chinese Hypertension Registry Study. BMI was categorized as < 24 and ≥ 24 kg/m². Multivariate logistic regression and smooth curve fitting (penalized spline method) were used to analyze the association between HDL-C and stroke in different BMI groups. Subgroup analysis and interaction tests were used to explore the effect of other variables on this relationship.

RESULTS

The results showed a negative association between HDL-C and stroke in the BMI < 24 kg/m² group, but HDL-C was not associated with stroke in the BMI ≥ 24 kg/m² group. In the BMI < 24 kg/m² group, each 1 mmol/L increase in HDL-C was associated with a 50% decreased risk of stroke [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.38-0.66]. No significant relationship between HDL-C and stroke was observed in the BMI ≥ 24 kg/m² group (OR 0.73, 95% CI 0.49-1.10). There was a significant interaction between BMI and HDL-C in regard to the prevalence of stroke in the hypertensive population without AF (P_Interaction = 0.027).

CONCLUSIONS

We found an inverse association between HDL-C and stroke only in the BMI < 24 kg/m² group. The finding suggested that BMI could modify the association between HDL-C and stroke in hypertensive populations without AF.

[Effect of tissue inhibitor of metalloproteinase-1 and 2 siRNA on the expression of smad2/3/4 protein in hepatic stellate cells]

Objective: To study the effect of tissue inhibitor of metalloproteinases (TIMP)-1 siRNA and TIMP-2 siRNA on the expression of smad2/3/4 protein in CCl4-induced liver fibrosis rat hepatic stellate cells (HSC). Methods: Rat's liver tissues with liver fibrosis after treatment with pre-built TIMP-1siRNA and TIMP-2 siRNA were used as the research subjects. Immunohistochemistry, Western blotting and real-time PCR were used to detect the protein and corresponding mRNA expression levels on smad2/3/4. TUNEL and α-smooth muscle actin (α-SMA) positive cells were quantified by double-labeled immunofluorescence. Analysis of variance (ANOVA) was used to compare the means between multiple groups, and the SNK test was used for the pairwise comparison of means. Results: The results of immunohistochemistry showed that the protein expressions of smad2, smad3, and smad4 in the TIMP-1 siRNA group and TIMP-2 siRNA group were significantly reduced than those of the model and the negative control group (P < 0.05). In addition, Western blotting results had also shown the same trend. The protein expression of smad2, smad3, and smad4 in the TIMP-1siRNA group and TIMP-2siRNA group were significantly reduced than those of the model and the negative control group (P < 0.01). The mRNA expression of smad2, smad3, and smad4 in TIMP-1siRNA group and TIMP-2siRNA group was significantly reduced than those of the model and negative control group (P < 0.05). Immunofluorescence showed that the apoptosis of activated HSC in the TIMP-1 siRNA group(0.014 3 ± 0.002 4) and TIMP-2 siRNA group(0.010 7 ± 0.004 4) was increased than those of the model(0) and the negative control group (0.002 4 ± 0.002 4, P < 0.05). Conclusion: TIMP-1 siRNA and TIMP-2 siRNA promote the apoptosis of activated HSCs. In addition, it also has a significant inhibitory effect on the expression of smad protein.

Same pandemic but different studies: an exploration of COVID-19 research at the early stage

OBJECTIVE

Scientific research is an essential necessity for the prevention and control of COVID-19. Accelerated paper-sharing makes it possible to explore the responses of scientific communities of different countries and their research focus. This is achieved by examining relevant publications during the early stage of the pandemic. This paper explores a timely research assessment on COVID-19 among China, USA, and EU.

MATERIALS AND METHODS

Papers indexed in PubMed and published from December 30, 2019, to March 11, 2020, were selected. Papers from China, USA, and EU were assessed by calculating the significance of items in the co-occurrence exported from VOSviewer.

RESULTS

The results showed that Chinese studies focus more on clinical manifestations, while USA and EU focus on experimental research. Furthermore, US research is more geared toward detection techniques and mathematical models, China focuses more on monitoring the epidemic situation, and EU engages in both.

CONCLUSIONS

This paper argues that the above distinctions are caused by differences in the stages of epidemic development, researchers' experience bases for formulating measures, traditions within the different medical cultures, and the distinction between "information" and "knowledge".

Expression, purification and characterization of three odorant binding proteins from the diamondback moth, Plutella xylostella

Odorant binding proteins (OBPs) are critical components in insect olfactory systems where they bind, solubilize and transport odorant molecules to receptors. Here, we cloned three OBPs (PxylGOBP1, PxylGOBP2 and PxylOBP24) from the diamondback moth, Plutella xylostella, one of the most destructive pests of cruciferous crops. These three OBPs were expressed in Escherichia coli as recombinant proteins, purified and characterized by fluorescence binding assays with 39 ligands including sex pheromone and plant-derived chemical compounds. PxylGOBP1 and PxylGOBP2 showed significantly different binding affinities to theses ligands, suggesting distinct binding preferences of these two general odorant binding proteins. PxylOBP24 showed no or extremely low binding activities to selected ligands, suggesting it may be involved in non-olfactory functions. Circular dichroism spectral results demonstrated that PxylGOBP1 and PxylGOBP2 shared similar secondary structures while PxylOBP24 was significantly different. This study improves our knowledge of insect OBPs, which will assist in a better understanding of insect olfactory system and developing more environmentally friendly pest control strategies for P. xylostella.

Biotransformation of insecticide flonicamid by Aminobacter sp. CGMCC 1.17253 via nitrile hydratase catalysed hydration pathway

AIMS

This study evaluates flonicamid biotransformation ability of Aminobacter sp. CGMCC 1.17253 and the enzyme catalytic mechanism involved.

METHODS AND RESULTS

Flonicamid transformed by resting cells of Aminobacter sp. CGMCC 1.17253 was carried out. Aminobacter sp. CGMCC 1.17253 converts flonicamid into N-(4-trifluoromethylnicotinoyl) glycinamide (TFNG-AM). Aminobacter sp. CGMCC 1.17253 transforms 31·1% of the flonicamid in a 200 mg l^-1 conversion solution in 96 h. Aminobacter sp. CGMCC 1.17253 was inoculated in soil, and 72·1% of flonicamid with a concentration of 0·21 μmol g^-1 was transformed in 9 days. The recombinant Escherichia coli expressing Aminobacter sp. CGMCC 1.17253 nitrile hydratase (NHase) and purified NHase were tested for the flonicamid transformation ability, both of them acquired the ability to transform flonicamid into TFNG-AM.

CONCLUSIONS

Aminobacter sp. CGMCC 1.17253 transforms flonicamid into TFNG-AM via hydration pathway mediated by cobalt-containing NHase.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report that bacteria of genus Aminobacter has flonicamid-transforming ability. This study enhances our understanding of flonicamid-degrading mechanism. Aminobacter sp. CGMCC 1.17253 has the potential for bioremediation of flonicamid pollution.

Effect of the baseline pulse wave velocity on short term and long term blood pressure control in primary hypertension

OBJECTIVES

Arterial stiffness may affect antihypertensive response to antihypertensive treatment. However, sufficient clinical evidence is lacking. This longitudinal study aimed to evaluate the effect of baseline arterial stiffness measured by the brachial-ankle pulse wave velocity (baPWV) on response to short-term and long-term enalapril-based treatment in 3310 hypertensive adults from the China Stroke Primary Prevention Trial (CSPPT).

METHODS AND RESULTS

Blood pressure (BP) measured at three months (short-term) in 2780 subjects, and the time-average on-treatment BP in 3310 subjects during a median of 4.5-year follow-ups (long-term) were analyzed in the study. After short-term antihypertensive treatment, every 1 m/s increase in baPWV denoted a 7% and 6% decreased chance of achieving systolic BP (SBP) control (odds ratio (OR), 0.93; 95% CI 0.90, 0.96; P < 0.001) and BP control (OR, 0.94; 95% CI 0.91, 0.97; P < 0.001), respectively, after adjustment for age, gender and other variables. After long-term treatment, every 1 m/s increase in baPWV posed an 7% and 6% greater risk of failing to attain SBP control (OR, 0.93; 95% CI 0.90, 0.95; P < 0.001) and BP control (OR, 0.94; 95% CI, 0.92, 0.96; P < 0.001), respectively, not regarding for DBP control after both short- and long-term treatment. Higher baseline baPWV significantly decreased SBP reduction both after three months and the median 4.5-year treatment, while increased DBP reduction after the median 4.5-year treatment.

CONCLUSIONS

Elevated baseline baPWV significantly decreased BP response to short-and long-term treatment in adults with primary hypertensive. Arterial stiffness improvement may be an essential target to achieve adequate BP control.