Ambulatory arterial stiffness indices and target organ damage in hypertension

Abstract

BackgroundThe present study was designed to evaluate which arterial stiffness parameter - AASI or the home arterial stiffness index (HASI) - correlates best with vascular, cardiac and renal damage in hypertensive individuals.MethodsA cross-sectional study was carried out involving 258 hypertensive patients. AASI and HASI were defined as the 1-regression slope of diastolic over systolic blood pressure readings obtained from 24-hour recordings and home blood pressure over 6 days. Renal damage was evaluated by glomerular filtration rate (GFR) and microalbuminuria; vascular damage by carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI); and left ventricular hypertrophy by the Cornell voltage-duration product (VDP) and the Novacode index.ResultsAASI and HASI were not correlated with microalbuminuria, however AASI and HASI- blood pressure variability ratio (BPVR) showed negative correlation with GRF. The Cornell PDV was positively correlated with AASI- BPVR-Sleep (r = 0.15, p < 0.05) and the left ventricular mass index with HASI-BPVR (r = 0.19, p < 0.01). Carotid IMT and PWV were positively correlated with all the parameters except the HASI, while ABI was negatively correlated with AASI and Awake-AASI. After adjusting for age, gender and 24 hours heart rate, statistical significance remains of the IMT with AASI, Awake AASI and AASI-BPVR. PWV with the AASI, Awake-AASI and Sleep-AASI. ABI with AASI and Awake-AASI. Odd Ratio to presence target organ damage was for AASI: 10.47(IC95% 1.29 to 65.34), Awake-AASI: 8.85(IC95% 1.10 to 71.04), Sleep-AASI: 2.19(IC95% 1.10 to 4.38) and AASI-BPVR-night: 4.09 (IC95% 1.12 to 14.92).ConclusionsAfter adjusting for age, gender and 24-hour heart, the variables that best associated with the variability of IMT, PWV and ABI were AASI and Awake-AASI, and with GFR was HASI-BPVR.

High Ambulatory Arterial Stiffness Index Is an Independent Risk Factor for Rapid Age-Related Glomerular Filtration Rate Decline in the General Middle-Aged Population

“…[27][28][29][30][31][32][33][34][35][36][37] To our knowledge, there have been no previous population-based studies of arterial stiffness using measurements of GFR instead of estimates and no longitudinal studies of the effects of AASI on renal end points. Three previous longitudinal, population-based studies of estimated GFR decline used carotid femoral pulse wave velocity (PWV).…”

Ambulatory arterial stiffness index correlates with ambulatory pulse pressure but not dipping status in patients with grade 1/grade 2 essential hypertension

“…5,17,32 Additional data supporting AASI as a reliable assessment of vascular stiffness include the findings of its association with other measures of vascular compliance, such as carotid intima-media thickness, pulse wave velocity and augmentation index. 5,13,15,[32][33][34] The observations that AASI predicts 12 and that renal disease increases AASI (but not pulse pressure) in patients with hypertension, 35 indicate that AASI is not merely reflecting alterations in pulse pressure. Some authors have argued, however, that AASI is dependent on the degree of nocturnal BP fall, and is only weakly associated with pulse wave velocity.…”

Geographic Variations in In‐Hospital Mortality and Use of Percutaneous Coronary Intervention Following Acute Myocardial Infarction in China: A Nationwide Cross‐Sectional Analysis

“…The prognosis for AMI varies significantly among patients for many reasons, including diversity in sex, race, age, AMI subtype, comorbidity, and treatment strategy 14, 15, 17, 18. Percutaneous coronary intervention (PCI) is now an effective treatment for AMI 19. Studies from the United States and Canada have reported that IHM rates were significantly lower for AMI patients who underwent PCI 16, 20, 21…”