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The relationship between ambulatory arterial stiffness index and blood pressure variability in hypertensive patients.

Lee HT, Lim YH, Kim BK, Lee KW, Lee JU, Kim KS, Kim SG, Kim JH, Lim HK, Shin J, Kim YM - Korean Circ J (2011)

Bottom Line: AASI had a simple correlation with age (R=0.189, p<0.001), relative wall thickness (RWT) (R=0.115, p=0.019), left ventricular mass index (LVMI) (R=0.192, p<0.001), average systolic BP (SBP) (R=0.232, p<0.001), average pulse pressure (PP) (R=0.363, p<0.001), SD of diastolic BP (DBP) (R=-0.352, p<0.001), SD of PP (R=0.330, p<0.001), SD of heart rate (HR) (R=-0.268, p<0.001), and nocturnal dipping (R=-0.137, p=0.005).In multiple linear regression analysis model including clinical parameters and 24 hour-ABPM parameters, independent predictors of AASI were SD of PP (β=1.246, p<0.001), SD of DBP (β=-1.067, p<0.001), SD of SBP (β=-0.197, p<0.001), and non-dipper (β=0.054, p=0.033).AASI is closely correlated with BP variability.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT

Background and objectives: Ambulatory arterial stiffness index (AASI) is well known as a predictor of cardiovascular mortality in hypertensive patients. Mathematically, AASI reflect the standard deviation (SD) of blood pressure (BP) variation. AASI is measured higher levels in non-dipper than dipper. Thus, AASI has a possibility of not only reflecting arterial stiffness but also BP variability and/or autonomic nervous dysfunction.

Subjects and methods: Consecutive data from 418 untreated hypertensive patients were analyzed retrospectively. We examined the association between the 24-hour ambulatory BP monitoring (ABPM) parameters and AASI.

Results: AASI had a simple correlation with age (R=0.189, p<0.001), relative wall thickness (RWT) (R=0.115, p=0.019), left ventricular mass index (LVMI) (R=0.192, p<0.001), average systolic BP (SBP) (R=0.232, p<0.001), average pulse pressure (PP) (R=0.363, p<0.001), SD of diastolic BP (DBP) (R=-0.352, p<0.001), SD of PP (R=0.330, p<0.001), SD of heart rate (HR) (R=-0.268, p<0.001), and nocturnal dipping (R=-0.137, p=0.005). In multiple linear regression analysis model including clinical parameters and 24 hour-ABPM parameters, independent predictors of AASI were SD of PP (β=1.246, p<0.001), SD of DBP (β=-1.067, p<0.001), SD of SBP (β=-0.197, p<0.001), and non-dipper (β=0.054, p=0.033).

Conclusion: AASI is closely correlated with BP variability. The result of this study shows that AASI is not only a parameter for arterial stiffness, but also a parameter for BP variability.

No MeSH data available.


Related in: MedlinePlus

Derivation of the ambulatory arterial stiffness index (AASI) from a 24 hour ambulatory blood pressure recording.
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Figure 1: Derivation of the ambulatory arterial stiffness index (AASI) from a 24 hour ambulatory blood pressure recording.

Mentions: Clinic BP was measured by a mercury sphygmomanometer, and defined as the average of at least 2 measurements recorded 3 minutes apart. Five physicians were involved in the measurement of clinic BP. Standardization quality was not validated. ABPM was recorded during a routine day by a TM-2430 device (A&D, Saitama, Japan). The device was applied to the non-dominant arm for 24 hours. BP was measured every 15 minutes during daytime, and every 30 minutes at nighttime. Patients were instructed to maintain their usual activities during monitoring, and to stay calm when the device started to work. Daytime and nighttime periods were defined individually according to the patients' self-reported data. As displayed in Fig. 1, raw data were examined by a scatter plot and the regression slope of DBP on SBP was computed to obtain an AASI (1-slope).3) The average mean arterial pressure (AMAP), SBP, DBP, pulse pressure (PP) and HR were calculated. The SDs of SBP, DBP, PP and HR were also calculated as parameters of BP and HR variability. Nocturnal dipping (%) is defined by percent decrease in nocturnal systolic BP compared to daytime systolic BP. When patients exhibited nocturnal dipping of less than 10%, they were defined as non-dippers.


The relationship between ambulatory arterial stiffness index and blood pressure variability in hypertensive patients.

Lee HT, Lim YH, Kim BK, Lee KW, Lee JU, Kim KS, Kim SG, Kim JH, Lim HK, Shin J, Kim YM - Korean Circ J (2011)

Derivation of the ambulatory arterial stiffness index (AASI) from a 24 hour ambulatory blood pressure recording.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116100&req=5

Figure 1: Derivation of the ambulatory arterial stiffness index (AASI) from a 24 hour ambulatory blood pressure recording.
Mentions: Clinic BP was measured by a mercury sphygmomanometer, and defined as the average of at least 2 measurements recorded 3 minutes apart. Five physicians were involved in the measurement of clinic BP. Standardization quality was not validated. ABPM was recorded during a routine day by a TM-2430 device (A&D, Saitama, Japan). The device was applied to the non-dominant arm for 24 hours. BP was measured every 15 minutes during daytime, and every 30 minutes at nighttime. Patients were instructed to maintain their usual activities during monitoring, and to stay calm when the device started to work. Daytime and nighttime periods were defined individually according to the patients' self-reported data. As displayed in Fig. 1, raw data were examined by a scatter plot and the regression slope of DBP on SBP was computed to obtain an AASI (1-slope).3) The average mean arterial pressure (AMAP), SBP, DBP, pulse pressure (PP) and HR were calculated. The SDs of SBP, DBP, PP and HR were also calculated as parameters of BP and HR variability. Nocturnal dipping (%) is defined by percent decrease in nocturnal systolic BP compared to daytime systolic BP. When patients exhibited nocturnal dipping of less than 10%, they were defined as non-dippers.

Bottom Line: AASI had a simple correlation with age (R=0.189, p<0.001), relative wall thickness (RWT) (R=0.115, p=0.019), left ventricular mass index (LVMI) (R=0.192, p<0.001), average systolic BP (SBP) (R=0.232, p<0.001), average pulse pressure (PP) (R=0.363, p<0.001), SD of diastolic BP (DBP) (R=-0.352, p<0.001), SD of PP (R=0.330, p<0.001), SD of heart rate (HR) (R=-0.268, p<0.001), and nocturnal dipping (R=-0.137, p=0.005).In multiple linear regression analysis model including clinical parameters and 24 hour-ABPM parameters, independent predictors of AASI were SD of PP (β=1.246, p<0.001), SD of DBP (β=-1.067, p<0.001), SD of SBP (β=-0.197, p<0.001), and non-dipper (β=0.054, p=0.033).AASI is closely correlated with BP variability.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT

Background and objectives: Ambulatory arterial stiffness index (AASI) is well known as a predictor of cardiovascular mortality in hypertensive patients. Mathematically, AASI reflect the standard deviation (SD) of blood pressure (BP) variation. AASI is measured higher levels in non-dipper than dipper. Thus, AASI has a possibility of not only reflecting arterial stiffness but also BP variability and/or autonomic nervous dysfunction.

Subjects and methods: Consecutive data from 418 untreated hypertensive patients were analyzed retrospectively. We examined the association between the 24-hour ambulatory BP monitoring (ABPM) parameters and AASI.

Results: AASI had a simple correlation with age (R=0.189, p<0.001), relative wall thickness (RWT) (R=0.115, p=0.019), left ventricular mass index (LVMI) (R=0.192, p<0.001), average systolic BP (SBP) (R=0.232, p<0.001), average pulse pressure (PP) (R=0.363, p<0.001), SD of diastolic BP (DBP) (R=-0.352, p<0.001), SD of PP (R=0.330, p<0.001), SD of heart rate (HR) (R=-0.268, p<0.001), and nocturnal dipping (R=-0.137, p=0.005). In multiple linear regression analysis model including clinical parameters and 24 hour-ABPM parameters, independent predictors of AASI were SD of PP (β=1.246, p<0.001), SD of DBP (β=-1.067, p<0.001), SD of SBP (β=-0.197, p<0.001), and non-dipper (β=0.054, p=0.033).

Conclusion: AASI is closely correlated with BP variability. The result of this study shows that AASI is not only a parameter for arterial stiffness, but also a parameter for BP variability.

No MeSH data available.


Related in: MedlinePlus