COMPARISON OF INFLUENCE OF OFFICE PULSE WAVE VELOCITY AND 24-HOUR AMBULATORY RECORDING OF AORTIC PULSE WAVE VELOCITY ON TARGET DAMAGE IN HYPERTENSION

Abstract

Objective: Arterial stiffness, as measured by pulse wave velocity (PWV), is a significant determinant of target organ damage (TOD). The aim of this study was to assess the potential use of office PWV and 24-hour PWV for prediction of subclinical TOD in a hypertensive cohort. Design and method: We evaluated associations of TOD with office carotid-femoral pulse wave velocity (O-cf-PWV) by radial tonometry (SphygmoCor) and 24-hour ambulatory PWV measurements (24h-PWV, including day-PWV and night-PWV) by brachial oscillometry (Mobil-O-Graph 24h PWA Monitor) in 636 hospital inpatients (age 54 ± 13 years, 465 males) with primary hypertension. Subclinical TOD was defined as left ventricular hypertrophy (LVH) obtained by echocardiography, carotid intima-media thickness (IMT) >0.9mm and chronic kidney disease (CKD) including urine albumin/creatinine ratio (ACR) >3.5 mg/mmol in females and >2.5 mg/mmol in males or estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. Results: After adjusting for confounding factors, both O-cf-PWV and 24h-PWV or night-PWV showed significant association with LV mass index (p<0.05). Only day-PWV was associated with eGFR (p = 0.039). When O-cf-PWV and 24h-PWV, including other confounding factors, were forced into the same logistic regression model, only O-cf-PWV (OR = 1.117, 95% CI:1.009-1.236, p = 0.033) remained significant determinants of increased LVH. Each 1 m/s increase in 24-h-PWV and day-PWV was associated with decreased risk of eGFR (odds ratio [OR] = 0.340 and 0.43, respectively). Only each increase in night-PWV was associated with risk of carotid IMT > 0.9 mm (OR = 1.360, 95% CI: 1.004 -1.843, p = 0.047). For ACR, neither 24-h-PWV nor O-cf-PWV was significant. Conclusions: O-cf-PWV improved prediction of LVH compared to ambulatory 24h-PWV under ambulatory conditions. Day-PWV may improve prediction of eGFR decline.