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.
Highlights
The 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
After adjusting for age, gender and 24-hour heart, the variables that best associated with the variability of intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/ brachial index (ABI) were AASI and Awake-AASI, and with glomerular filtration rate (GFR) was HASI-blood pressure variability ratio (BPVR)
While HASI is not correlated to any of the parameters used to evaluate the presence of target organ damage (TOD) in hypertensive patients, HASI-BPVR is positively correlated with IMT and PWV, and shows a negative correlation with GFR, in the same way as the AASI indices except Sleep-AASI, which shows a negative correlation with GFR
Summary
The 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. The ambulatory arterial stiffness index (AASI) is related to cardiovascular morbidity-mortality [1,2] and to the presence of associated target organ damage (TOD) in hypertensive patients [3,4,5,6,7,8]. If not found to be similar, we can determine whether AASI and HASI are correlated differently with other vascular, cardiac or renal lesions, and whether they can have different implications in clinical practice
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