Association Between Healthy and Non-healthy Vascular Aging with Hypertensive Target Organ Damage in Hospitalized Patients

Abstract Objective To investigate the correlation between healthy vascular aging (HVA) and non-healthy vascular aging (NHVA) with hypertensive target organ damage (TOD). Methods This study included individuals from the Geriatrics Department of Ruijin Hospital in Shanghai since January 2023. The participants were divided into HVA and NHVA groups based on blood pressure and carotid-femoral pulse wave velocity (cf-PWV). HVA was defined as no history of hypertension and cf-PWV < 7.6 m/s; NHVA was defined as a history of hypertension or cf-PWV ≥ 7.6 m/s. The hypertensive TOD indicators included carotid intima-media thickness (cIMT), chronic kidney disease, albumin-to-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and left ventricular mass index (LVMI). Results A total of 1257participants was included in the study. After grouping by cf-PWV and blood pressure, 31.8% met the HVA criteria. Compared to the HVA group, the NHVA group was older, had more smokers, and exhibited higher levels body mass index, blood glucose, lipids, and blood pressure. The NHVA group also showed lower creatinine clearance (88.7 ± 17.2 mL/min/1.73 m 2 vs.93.4 ± 15.8 mL/min/1.73 m 2 , p < 0.001), higher LVMI (108.0 ± 26.4 g/m 2 vs. 92.3 ± 22.3 g/m 2 , p < 0.001), greater cIMT (0.8 ± 0.1 mm vs. 0.7 ± 0.1 mm, p < 0.001), and higher cf-PWV (9.1 ± 1.9 m/s vs.6.5 ± 0.7 m/s, p < 0.001). Multivariate linear regression analysis revealed significant associations between vascular aging groups and LVMI ( p = 0.006) and lgACR ( p = 0.023). The binary stepwise logistic regression results demonstrated a significant correlation between vascular aging and LVMI (OR = 2.201, 95% CI: 1.299–3.73, p = 0.003). Conclusion Accelerated vascular aging is associated with cardiac and renal TOD, providing a potential target for intervention among hospitalized patients. Vascular aging shows a significant correlation with LVMI in-hospital patients.