Background: Blood pressure (BP) can be separated into mean arterial pressure (MAP) and pulsatile (pulse pressure, PP) components which may relate differently to atherosclerosis and arteriosclerosis. The aim of the study was to examine the association between longitudinal measures of MAP and PP (central and peripheral) with measures of atherosclerosis and arterial stiffness.

Methods: Subjects comprised 411 apparently healthy female twins, which had measures of central and brachial BP made between 1996–2001 (aged 24–72 years) and second between 2006–2010, as part of the TwinsUK programme of research. Central BP was estimated using the SphygmoCor system from transformed radial waveforms. Carotid-femoral pulse wave velocity (cfPWV) and presence of carotid/femoral plaque was determined at follow-up. Associations of cfPWV and plaque to BP components at baseline and the progression of these over the 10 year follow-up period were examined using linear and logistic regression analysis.

Results: Baseline predictors of cfPWV at follow-up were age and MAP (standardized beta coefficients, β=0.42, and 0.12, respectively). When progression of BP components was included in the model, cfPWV correlated positively with progression of central PP, HR and MAP (β=0.33, 0.33, 0.16, respectively). Using logistic regression analysis, the only baseline predictor of plaque was MAP (β=0.03, P<0.05), progression of BP components was not significantly correlated with presence of plaque.

Conclusion: MAP is an independent predictor of both plaque and increased arterial stiffness at 10 year follow-up, whereas PP progression correlates with cfPWV but not plaque. These findings suggest a differential association between atherosclerosis and arteriosclerosis to BP components.