Association of augmentation index of radial pressure wave form with diurnal variation pattern of blood pressure in untreated patients with essential hypertension

Shinohata, Ryoko; Nakatsu, Takaaki; Yuki, Yoko; Nishitani, Aya; Mashima, Keiichi; Toyonaga, Shinji; Ogawa, Hiroyasu; Hirohata, Satoshi; Usui, Shinichi; Kitawaki, Tomoki; Kusachi, Shozo

doi:10.1097/hjh.0b013e3282f2fdb6

Cited by 15 publications

(18 citation statements)

References 32 publications

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“…The first study to address this issue, 23 which evaluated 106 untreated hypertensive individuals, found that aortic PWV was an independent predictor of the nocturnal SBP reduction. Similarly, three other studies [24][25][26] reported significant associations between the non-dipping pattern and arterial stiffness. Abbreviations: HDL, high-density lipoprotein; SBP, systolic blood pressure; PP, partial pressure; UAER, urinary albumin excretion rate.…”

Section: Discussionmentioning

confidence: 99%

A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension

et al. 2009

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Increased arterial stiffness may be causally related to resistant hypertension. Our objective was to investigate the variables, particularly those derived from ambulatory blood pressure (BP) monitoring (ABPM), associated with increased aortic stiffness in resistant hypertensives. In a cross-sectional study, 600 resistant hypertensive patients without peripheral arterial disease were evaluated. Arterial stiffness was assessed by aortic pulse wave velocity (PWV), and was considered increased if 412 m s À1 . Statistical analyses included multiple linear and logistic regressions to assess the independent correlates of increased aortic stiffness. One hundred and sixty-eight patients (28%) had aortic PWV 412 m s À1 . Patients with increased PWV were older and had a higher prevalence of cardiovascular risk factors than did those patients with low PWV. On ABPM, patients with elevated PWV had higher daytime and night time systolic BP (SBP) and pulse pressures (PP), less nocturnal decrease in SBP and a higher prevalence of non-dipping pattern. On multiple linear regression, the independently associated variables with aortic PWV were age (Po0.001), 24-h PP (Po0.001), high-density lipoprotein (HDL)-cholesterol (Po0.001), microalbuminuria (Po0.001), fasting glycemia (P¼0.001) and a decrease in nocturnal SBP (P¼0.002). Multivariate logistic regression confirmed these results, with the non-dipping patients having a 72% higher likelihood of presenting with increased aortic stiffness (95% confidence interval: 1.12-2.65, P¼0.013). This association was observed in both the reduced and reverted dipping patterns, but not in the extreme dipping pattern. In conclusion, a blunted nocturnal decrease in BP is independently associated with increased aortic stiffness in resistant hypertensive patients. Other independent correlates are older age, diabetes, microalbuminuria, low HDL-cholesterol and a widened 24-h PP.

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Section: Discussionmentioning

confidence: 99%

A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension

et al. 2009

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“…8 AI can be determined noninvasively by pulse wave analysis of the radial artery, and provides information on cardiac load and vascular properties. 9,10 The usefulness of AI measured from radial pressure waveform has been shown in earlier studies. 10,11 As another parameter of arterial stiffness, the cardio-ankle vascular index (CAVI), which reflects the stiffness of the aorta independently of blood pressure, has been developed recently.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 The usefulness of AI measured from radial pressure waveform has been shown in earlier studies. 10,11 As another parameter of arterial stiffness, the cardio-ankle vascular index (CAVI), which reflects the stiffness of the aorta independently of blood pressure, has been developed recently. 12 CAVI was reported to be associated with atherosclerosis, 13 cardiovascular risk factors 14 and LV diastolic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

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Augmentation index is associated with B-type natriuretic peptide in patients with paroxysmal atrial fibrillation

et al. 2009

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B-type natriuretic peptide (BNP) levels have been shown to be elevated in patients with paroxysmal atrial fibrillation (PAF); however, the underlying mechanisms have not been fully elucidated. Earlier, we reported that an increase in the augmentation index (AI), which is an index of wave reflection and arterial stiffness, is associated with PAF. In this study, we investigate the relationship between the BNP level and AI in patients with PAF. We enrolled 92 patients with a history of PAF and 90 age-and gender-matched individuals without PAF. AI was calculated using applanation tonometry of the radial artery when all patients were on sinus rhythm. Plasma BNP levels were measured simultaneously. An arterial stiffness parameter, the cardio-ankle vascular index (CAVI), was also evaluated. The increased AI in patients with PAF correlated with the elevation of the BNP level (r¼0.47, Po0.01). When PAF patients were classified into tertiles on the basis of the BNP level, the left atrial volume index, left ventricular mass index, AI and CAVI increased, and mitral annular e¢ velocity (e¢), as an index of left ventricular diastolic pressure, decreased with BNP tertiles. AI was also associated with e¢ and left ventricular mass index. Multiple regression analysis showed that the AI in PAF patients independently correlated with BNP levels. This study showed that AI was an independent correlate of the BNP level in PAF patients. Left ventricular diastolic dysfunction, which linked to an increase in arterial stiffness, may be involved in the elevated BNP level. INTRODUCTIONThe B-type natriuretic peptide (BNP) is a neurohormone secreted from cardiac ventricles in response to ventricular volume and pressure overload. 1 The BNP level does not only significantly correlate with the left ventricular (LV) filling pressure but also reflects symptomatic LV dysfunction and prognosis. 2 Although BNP has been reported to be an excellent screening tool for LV dysfunction, some patients with paroxysmal atrial fibrillation (PAF) or coronary artery disease have been shown to have a high BNP level, independent of LV systolic function; 3,4 however, the underlying mechanisms of the increase in BNP level in patients with PAF have not been fully elucidated.Our recent study showed that the augmentation index (AI) obtained from the radial artery is increased in patients with PAF. 5 AI, determined from either a directly measured or derived central arterial pressure wave form, has been proposed as a measure of aortic stiffness and wave reflection. 6 Earlier studies have shown that AI is closely related to several risk factors for atherosclerosis 7 and cardiovascular diseases. 8 AI can be determined noninvasively by pulse wave

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“…ND attenuation was associated with the presence of other cardiovascular risk factors (obesity and lower HDL-c) and also with a higher frequency of lesion in target-organ. Studies on the prevalence of cardiovascular and cerebral events varies greatly in the specific literature (Table 5), reaching a frequency of 37.5 to 64.2% [11][12][13][14][15][16][17][18][19][20][21] under several factors' influence, like the definition of sleep and vigil periods 22 .…”

Section: Discussionmentioning

confidence: 99%

Ausência de descenso noturno se associa a acidente vascular cerebral e infarto do miocárdio

Vaz-de-Melo¹,

Loureiro²,

Cipullo³

et al. 2010

Arq. Bras. Cardiol.

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Association of augmentation index of radial pressure wave form with diurnal variation pattern of blood pressure in untreated patients with essential hypertension

Cited by 15 publications

References 32 publications

A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension

A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in patients with resistant hypertension

Augmentation index is associated with B-type natriuretic peptide in patients with paroxysmal atrial fibrillation

Ausência de descenso noturno se associa a acidente vascular cerebral e infarto do miocárdio

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