Purpose/Background/Objectives: Hypertension is associated with several markers of subclinical target organ damage (TOD). Total arterial compliance (TAC) is a prognostic factor for cardiovascular events. We hypothesized that there is a relationship between TAC and TOD in never-treated hypertensives.

Methods: We enrolled 990 consecutive essential hypertensives (mean age 52.6±12.2 years, 526 males). Markers of subclinical TOD [left ventricular mass index (LVMI), pulse wave velocity (PWV), ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR)] were evaluated in all patients. LVMI was assessed echocardiographically using the Devereux formula. Carotid-femoral PWV was estimated with the Complior. eGFR was calculated by the Cockcroft-Gault formula. ABI was calculated by dividing the highest ankle systolic blood pressure by the highest brachial systolic blood pressure. The ratio of stroke volume to pulse pressure was measured echocardiographically as a surrogate of TAC.

Results: In multivariable regression analysis, TAC exhibited significant association with LVMI (p=0.004, adjusted R2 of model=0.400), PWV (p<0.001, adjusted R2 of model=0.298) ABI (p=0.002, adjusted R2 of model=0.009) but not with eGFR. In further analysis, TAC was associated with the number of TOD markers (p<0.001) as suggested by the 2013 European Guidelines for Hypertension [left ventricular hypertrophy (LVMI>115 g/m2 in men and >95 g/m2 in women), increased PWV (PWV>10m/s), decreased ABI (ABI<0.9) and decreased renal function (eGFR<60ml/min)]. In logistic regression model increasing TAC was associated with a reduction in the likelihood of TOD, similarly to the multivariable regression model. (P<0.05 for all X eGFR).

Conclusions: Our findings support the relationship between TAC and TOD in hypertension.