Impact of Blood Pressure Across the Life Course on Arterial Stiffness in Midlife: The Mediating Role of Metabolic Factors
Childhood blood pressure (BP) is associated with increased arterial stiffness later in life. This study aimed to investigate the contributions of BP across different life stages to midlife arterial stiffness and the mediating role of metabolic factors. Using data from the Hanzhong Adolescent Hypertension Study, 1448 participants aged 6-18 years at baseline were prospectively followed for 30 years into adulthood. We used linear regression models to examine the associations between BP at different life stages and brachial-ankle pulse wave velocity (baPWV). In addition, parallel multiple mediation analyses were conducted to evaluate the mediating roles of blood glucose and lipid metabolism in these associations. Significant associations between BP and adult baPWV were observed across childhood, adulthood, and cumulative long-term BP burden, with BP in adulthood showing the strongest association. Additionally, the triglyceride-glucose index was identified as a mediator in the relationship between adult BP and midlife baPWV, with the mediation effects more pronounced among males. Our findings suggest that the detrimental impact of elevated BP on arterial stiffness begins early in life and intensifies over the lifespan, particularly during adulthood. Furthermore, the association between adult BP and arterial stiffness appears to be partially mediated by insulin resistance.
Authors
- Yang Wang (ORCID: https://orcid.org/0000-0002-7717-5031)
- Ying Xiong (ORCID: https://orcid.org/0000-0002-6270-5220)
- Guilin Hu (ORCID: https://orcid.org/0000-0001-6703-9135)
- Jianjun Mu (ORCID: https://orcid.org/0000-0002-0335-3528)
- Yu‐Ming Kang (ORCID: https://orcid.org/0000-0002-5002-4655)
- Yao Lu (ORCID: https://orcid.org/0000-0001-6743-7870)
- Lei Chen (ORCID: https://orcid.org/0000-0002-9380-9559)
- Zi‐Yue Man
- Ming‐Fei Du
- Sheng Hong Liu (ORCID: https://orcid.org/0000-0001-5933-1101)
- Hao Jia (ORCID: https://orcid.org/0000-0002-4736-0957)
- Tongshuai Guo (ORCID: https://orcid.org/0000-0002-1533-7461)
- Ze‐Jiaxin Niu (ORCID: https://orcid.org/0009-0000-7746-8064)
- Hao Li (ORCID: https://orcid.org/0000-0002-2171-8826)
- Teng Zhang (ORCID: https://orcid.org/0000-0002-5310-8766)
- Yu Yan (ORCID: https://orcid.org/0000-0001-5942-5853)
- Dan Wang (ORCID: https://orcid.org/0000-0002-9758-3614)
- Xi Zhang (ORCID: https://orcid.org/0000-0001-6148-8837)
- Zuyi Yuan (ORCID: https://orcid.org/0000-0002-4141-0298)
- Ruiyu Wang (ORCID: https://orcid.org/0000-0001-6574-5888)
- Yue Sun (ORCID: https://orcid.org/0000-0001-5409-2527)
- Tian Zi-qiang
- Chao Chu
- Gregory Lip
- Ming‐Ke Chang
- Shengzhe Zuo
Institutions
- Central South University (CN)
- Medical University of Białystok (PL)
- University of Liverpool (GB)
- Liverpool Heart and Chest Hospital (GB)
- First Affiliated Hospital of Xi'an Jiaotong University (CN)
- Third Xiangya Hospital (CN)
- Xi'an Jiaotong University (CN)
- Aalborg University (DK)
Publication Details
- Journal
- MedComm
- Published
- 2025-10-22
- DOI
- https://doi.org/10.1002/mco2.70440
- Primary Topic
- Cardiovascular Health and Disease Prevention
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- Xi’an Jiaotong University
- China Scholarship Council
- Fundamental Research Funds for the Central Universities
- Natural Science Basic Research Program of Shaanxi Province