Influence of the emotional alterations in the arterial stiffness index and cardiovascular risk of pre-hypertensive patients

Chronic kidney disease (CKD) affects approximately two million people (in a population of 20 million) in Romania. Hypertension is often associated with CKD and both (hypertension and CKD) are risk factors for cardiovascular (CV) events. Ambulatory blood pressure monitoring (ABPM) is increasingly used all around the world for the diagnosis and monitoring of BP (blood pressure) because it is proven that the ABPM is superior to office BP measurements in evaluating patients with hypertension, with or without CKD. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR). Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). It has prognostic value for cardiac death and stroke and several studies have showed that is negatively related to eGFR and is positively related to albuminuria. Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function. These facts suggest that ABPM offers multiple useful data with impact, not only in future CV and renal outcomes assessment, but also in the treatment and management of hypertensive patients with CKD.

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Parameters of arterial stiffness in hypertensive patients with and without subclinical carotid atherosclerosis

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-4-427-435 ◽

2021 ◽

Vol 27 (4) ◽

pp. 427-435

Author(s):

V. E. Gumerova ◽

S. A. Sayganov ◽

V. V. Gomonova

Keyword(s):

Arterial Stiffness ◽

Pulse Pressure ◽

Augmentation Index ◽

Subclinical Atherosclerosis ◽

Stiffness Index ◽

Control Group ◽

Hypertensive Patients ◽

Significant Difference ◽

Arterial Stiffness Index ◽

Plaque Detection

Objective. To assess the relationship between arterial stiffness parameters in hypertensive patients with and without atherosclerotic lesions.Design and methods. We included 127 subjects who were divided into 3 groups: patients with hypertension (HTN) without atherosclerosis (n = 42); patients with HTN and subclinical atherosclerosis (SА) (n = 52) and control group which consisted of individuals without HTN, SA, or coronary artery disease (n = 33). All groups matched by age and gender. All subjects underwent following examinations: ultrasonography of extracranial segments of carotid arteries, 24-hour blood pressure monitoring with the assessment of arterial stiffness parameters.Results. In subjects with HTN compared to controls, pulse wave velocity in aorta (PWVao) was significantly higher (11,3 ± 1,5; 12,3 ± 1,8 vs 10,4 ± 1,3 m/s; p < 0,05), as well as pulse pressure (PP) (46,4 ± 9,8; 45,6 ± 10,6 vs 39,9 ± 6,5 mmHg; p < 0,05), central pulse pressure (PPао) (35,5 ± 8,5; 34,9 ± 8,5 vs 30,9 ± 5,4 mmHg; p < 0,05), and arterial stiffness index (ASI) (141 (127, 159); 139 (128,5, 160,5) vs 126 (118, 138) mmHg; p < 0,05). In subjects with HTN and SA, PWVao was significantly higher compared to other groups (p < 0,05). No significant difference in augmentation index was found (–32,5 (–45, –12); –22 (–36, –12); –37 (–50, –17); p = 0,25). Аmbulatory arterial stiffness index was higher in controls (0,5 ± 0,2) compared to HTN group (0,4 ± 0,2; p = 0,05), while HTN and SA group did not differ significantly (0,5 ± 0,2; p = 0,3). PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection.Conclusions. In HTN patients, arterial stiffness is changed compared to healthy individuals. PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection. In patients with HTN and SA arterial stiffness is higher, which might have additional predictive value in risk stratification.

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Two-Day ABPM-Derived Indices and Mortality in Hemodialysis Patients

American Journal of Hypertension ◽

10.1093/ajh/hpz166 ◽

2019 ◽

Author(s):

Francesca Viazzi ◽

Francesca Cappadona ◽

Giovanna Leoncini ◽

Elena Ratto ◽

Annalisa Gonnella ◽

...

Keyword(s):

Cardiovascular Risk ◽

Arterial Stiffness ◽

Prognostic Significance ◽

Strong Relationship ◽

Stiffness Index ◽

Ambulatory Bp Monitoring ◽

All Cause Mortality ◽

Arterial Stiffness Index ◽

Reverse Dipping

Abstract BACKGROUND Blood pressure (BP) and arterial stiffness are known cardiovascular risk factors in hemodialysis (HD) patients. This study examines the prognostic significance of 44-hour BP circadian rhythm and ambulatory arterial stiffness index (AASI) in this population. METHODS A total of 80 HD patients underwent 44-hour ambulatory BP monitoring (ABPM) with a TM-2430 monitor during a standard midweek interdialytic interval and followed up for 4.5 ± 1.7 years. The end point was all-cause mortality. RESULTS About 76% of participants were hypertensive (40% uncontrolled), 62% were nondippers, and 23% risers during the first interdialytic day, whereas 73% and 44% in the second day, respectively. During follow-up, 31 patients (40%) died. These showed higher pulse pressure (PP) and AASI44 and AASI of the second interdialytic period. The incidence of all-cause mortality was higher in HD patients with AASI44 > median, i.e. >0.54 (interquartile range = 14) (54% vs. 28%, χ 2 = 5.3, P = 0.021) when compared with those with lower AASI44. Second, but not first-day ABPM-derived parameters, namely nondipping (log-rank χ 2 = 6.10, P = 0.0134) or reverse dipping status (log-rank χ 2 = 5.32, P = 0.210) and arterial stiffness index (log-rank χ 2 = 6.61, P = 0.0101) were significantly related to greater mortality. CONCLUSIONS These findings indicate a strong relationship between arterial stiffness and cardiovascular risk and support a wider use of 44-hour ABPM recording for risk stratification in HD patients.

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The influence of baroreflex sensitivity on ambulatory arterial stiffness index in individuals with cardiovascular risk

Blood Pressure Monitoring ◽

10.1097/mbp.0b013e32833c8a7f ◽

2010 ◽

Vol 15 (5) ◽

pp. 262-267 ◽

Cited By ~ 7

Author(s):

Mei-Yeh Wang ◽

Chun-Jen Huang ◽

Yu-Lin Wu ◽

Ju-Chi Liu ◽

Pei-Shan Tsai

Keyword(s):

Cardiovascular Risk ◽

Arterial Stiffness ◽

Baroreflex Sensitivity ◽

Stiffness Index ◽

Arterial Stiffness Index

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Relationship between ambulatory arterial stiffness index and subclinical target organ damage in hypertensive patients

Hypertension Research ◽

10.1038/hr.2010.195 ◽

2010 ◽

Vol 34 (2) ◽

pp. 180-186 ◽

Cited By ~ 29

Author(s):

Ángel García-García ◽

Manuel A Gómez-Marcos ◽

José I Recio-Rodriguez ◽

Luis J González-Elena ◽

Javier Parra-Sanchez ◽

...

Keyword(s):

Arterial Stiffness ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Stiffness Index ◽

Hypertensive Patients ◽

Arterial Stiffness Index

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Association of renal function with the ambulatory arterial stiffness index and pulse pressure in hypertensive patients

Hypertension Research ◽

10.1038/hr.2011.167 ◽

2011 ◽

Vol 35 (2) ◽

pp. 201-206 ◽

Cited By ~ 8

Author(s):

Yaqiong Wang ◽

Yarong Hu ◽

Yan Li ◽

Hua Li ◽

Shaoli Chu ◽

...

Keyword(s):

Renal Function ◽

Arterial Stiffness ◽

Pulse Pressure ◽

Stiffness Index ◽

Hypertensive Patients ◽

Arterial Stiffness Index

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2.7 Ambulatory Arterial Stiffness Index and Cardiovascular Risk in a Sample of Hypertensive Adult Population

High Blood Pressure & Cardiovascular Prevention ◽

10.1007/bf03263600 ◽

2008 ◽

Vol 15 (3) ◽

pp. 189-189

Author(s):

L. D’Elia ◽

R. Ippolito ◽

D. De Palma ◽

G. Rossi ◽

P. Schiattarella ◽

...

Keyword(s):

Cardiovascular Risk ◽

Arterial Stiffness ◽

Adult Population ◽

Stiffness Index ◽

Arterial Stiffness Index

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Ambulatory Arterial Stiffness Index Is Higher in Hypertensive Patients with Chronic Kidney Disease

International Journal of Hypertension ◽

10.1155/2012/178078 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Ronaldo Altenburg Gismondi ◽

Mario Fritsch Neves ◽

Wille Oigman ◽

Rachel Bregman

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Arterial Stiffness ◽

Blood Pressure Monitoring ◽

Stiffness Index ◽

Hypertensive Patients ◽

Clinical Endpoints ◽

Mdrd Formula ◽

Arterial Stiffness Index

Ambulatory arterial stiffness index (AASI) is a parameter obtained from ambulatory blood pressure monitoring (ABPM) that correlates with clinical endpoints. The aim of this study was to compare AASI in nondiabetic hypertensive patients with and without chronic kidney disease (CKD). Subjects with systemic arterial hypertension (SAH,n=30) with normal renal function, aged 40 to 75 years, were compared to hypertensive patients with CKD (n=30) presenting estimated glomerular filtration rate (eGFR) <60 mL/min by MDRD formula. ABPM was carried out in all patients. In CKD group, eGFR was 35.3 ± 2.8 ml/min. The mean 24-hour systolic and diastolic blood pressure (BP) was similar in both groups. AASI was significantly higher in CKD group (0.45±0.03versus0.37±0.02,P<0.05), positively correlated to age (r=0.38,P<0.01) and pulse pressure (r=0.43,P<0.01) and negatively correlated to nocturnal BP fall (r=-0.28,P=0.03). These findings indicate the presence of stiffer vessels in CKD hypertensive patients.

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