Objective: Aortic stiffness, an independent cardiovascular risk factor, is strongly related to age and mean arterial pressure (MAP). In a general population, we investigated effect of antihypertensive treatment on aortic pulse wave velocity (aPWV) with respect to age and MAP.

Design and Methods: In a Czech post-MONICA study, we measured aPWV in 1007 subjects, mean age 54.5 years, 55.0% women, 33.8% on antihypertensive medication). We used linear regression analyses to assess effect of antihypertensive treatment on aPWV. As independent covariates we considered: sex, age (MAP), heart rate, body mass index, smoking, and observer.

Results: Subjects using antihypertensive treatment were older, had higher SBP, BMI and aPWV (P<0.0001). In analysis adjusted for MAP, but not in unadjusted analysis, use of antihypertensive medication diminished effect of age on aPWV (regression equations, untreated subjects (TRT-0): 5.74 + 0.032^*age vs. treated patients (TRT-1) 9.24 – 0.004^*age; difference of slope, F=28.9; P<0.0001). In both unadjusted (regression equations −1.80 + 0.096^*MAP vs. 6.38 + 0.026^*MAP; difference of slopes, F=28.7; P<0.0001) and analysis adjusted for age (3.81 + 0.037^*MAP vs. 9.55 − 0.0056^*MAP; difference of slopes, F=38.9: P<0.0001), use of antihypertensive treatment was associated with smaller increase of aPWV with MAP.

Conclusions: In a general population, we observed that use of antihypertensive medication reduce an increase of aPWV with age. The increase of aPWV with blood pressure was also smaller in treated patients compared to untreated subjects. Antihypertensive drugs prevent aortic stiffening even in subjects whose blood pressure is not well controlled.