Association of Hemoglobin with Ambulatory Arterial Stiffness Index in Untreated Essential Hypertensive Patients Without Anemia

Abstract

Objective Increased hemoglobin (Hb) levels are known to be associated with increased cardiovascular events and mortality in hypertensive patients, but the underlying mechanism remains unclear. However, an increased Ambulatory Arterial Stiffness Index (AASI), the surrogate maker of arterial stiffness, has been proven to be an independent predictor of cardiovascular disease. This pilot study evaluated the association between Hb and AASI in untreated essential hypertensive patients without anemia. Methods A total of 566 untreated essential hypertensive patients without anemia were divided into NormalHb and High-Hb groups according to their Hb levels. The AASI and its symmetric calculation (Sym_AASI) were derived from 24h-Ambulatory Blood Pressure Monitoring (24h-ABPM). A multivariable linear regression analysis was performed to determine the relationship between Hb and AASI, Sym_AASI. Results High-Hb group (n=127) showed higher AASI and Sym_AASI (0.51±0.11 vs 0.43±0.12, p<0.001; 0.33±0.10 vs 0.27±0.08, p<0.001) compared to Normal-Hb group (n=439). Univariate correlation analysis showed that Hb levels were positively related to AASI and Sym_AASI values (r=0.459, p<0.001; r=0.353, p<0.001). After adjustment for age, sex, BMI, current smoker, eGFR, uric acid, total cholesterol, high-density lipoprotein, 24h-SBP, 24h-PP and dipper status, Hb persisted as a independent determinant of AASI and Sym_AASI (β=0.402, p<0.001 and β=0.298, p<0.001, respectively). Conclusion High hemoglobin seems be to associated with increased AASI in untreated essential hypertensive patients without anemia.

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

“…38 In addition, AASI appears be higher in patients with hypertension and chronic renal disease than in those without renal chronic disease, 35 and is also increased in patients with diabetes, 32 acromegaly 38 and high haemoglobin levels. 39 The finding in the present study that AASI correlated with age was in keeping with numerous investigations that observed the same phenomenon in patients with hypertension. 5,15,17,18,[32][33][34][35] The association between a higher AASI and impaired renal function, determined by eGFR, was an additional relevant finding of the present study.…”

Association of ambulatory arterial stiffness index with sEPCR in newly diagnosed hypertensive patients

“…[3][4][5][23][24][25] Similar to other studies, we demonstrated higher AASI in the hypertensive patients versus controls. 26,27 The mean AASI value of Group 1 in this study was 0.46 ± 0.11. This is very similar to the mean AASI values [0.47 ± 0.16; 26 0.51 ± 0.11 27 ] reported in other studies of hypertensive patients.…”

“…26,27 The mean AASI value of Group 1 in this study was 0.46 ± 0.11. This is very similar to the mean AASI values [0.47 ± 0.16; 26 0.51 ± 0.11 27 ] reported in other studies of hypertensive patients. Therefore, increased AASI values in newly diagnosed hypertensive patients suggest increased arterial stiffness.…”

“…A positive correlation was found between AASI and BMI similar to other studies. 26,27 Some evidence has suggested that HDL-C is inversely and independently associated with arterial stiffness in the general population 36 as well as in hypertensive patients. 37 The results of our study are compatible with other reports in the literature, which show that while HDL is inversely correlated with AASI, it is an independent predictor of AASI.…”

Arterial stiffness in hematologic malignancies

“…Hemoglobin affects peripheral vascular resistance due to the effect on blood viscosity and caliber of peripheral arterioles 14. Montero et al15 concluded that arterial stiffness is strongly and inversely associated with the total volume of red blood cells in healthy individuals, suggesting that arterial stiffness may be involved in the regulation of erythropoiesis.…”