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Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study.

Omboni S, Posokhov IN, Rogoza AN - Int J Hypertens (2015)

Bottom Line: Methods.After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Clinical Research Unit, Italian Institute of Telemedicine, 21048 Solbiate Arno, Italy.

ABSTRACT
Objective. Central blood pressure (BP) and vascular indices estimated noninvasively over the 24 hours were compared between normotensive volunteers and hypertensive patients by a pulse wave analysis of ambulatory blood pressure recordings. Methods. Digitalized waveforms obtained during each brachial oscillometric BP measurement were stored in the device memory and analyzed by the validated Vasotens technology. Averages for the 24 hours and for the awake and asleep subperiods were computed. Results. 142 normotensives and 661 hypertensives were evaluated. 24-hour central BP, pulse wave velocity (PWV), and augmentation index (AI) were significantly higher in the hypertensive group than in the normotensive group (119.3 versus 105.6 mmHg for systolic BP, 75.6 versus 72.3 mmHg for diastolic BP, 10.3 versus 10.0 m/sec for aortic PWV, -9.7 versus -40.7% for peripheral AI, and 24.7 versus 11.0% for aortic AI), whereas reflected wave transit time (RWTT) was significantly lower in hypertensive patients (126.6 versus 139.0 ms). After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI. All estimates displayed a typical circadian rhythm. Conclusions. Noninvasive assessment of 24-hour arterial stiffness and central hemodynamics in daily life dynamic conditions may help in assessing the arterial function impairment in hypertensive patients.

No MeSH data available.


Related in: MedlinePlus

Daytime and nighttime reflected wave transit time (RWTT), aortic pulse wave velocity (PWV), peripheral and aortic augmentation index (AI), and central (aortic) systolic (SBP) and diastolic blood pressure (DBP) values in healthy controls (open bars) and hypertensive patients (gray bars). For RWTT, PWV, and AI not normalized and normalized data (corrected for SBP and/or heart rate) are represented. Data are shown as averages and 95% confidence intervals for crude estimates (a) and for adjusted estimates ((b) data adjusted by age, gender, body mass index, antihypertensive treatment, and 24-hour SBP and DBP). The asterisks indicate the level of the statistical significance of the difference between the two study groups (***P < 0.001; **P < 0.01; *P < 0.05).
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Related In: Results  -  Collection


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fig1: Daytime and nighttime reflected wave transit time (RWTT), aortic pulse wave velocity (PWV), peripheral and aortic augmentation index (AI), and central (aortic) systolic (SBP) and diastolic blood pressure (DBP) values in healthy controls (open bars) and hypertensive patients (gray bars). For RWTT, PWV, and AI not normalized and normalized data (corrected for SBP and/or heart rate) are represented. Data are shown as averages and 95% confidence intervals for crude estimates (a) and for adjusted estimates ((b) data adjusted by age, gender, body mass index, antihypertensive treatment, and 24-hour SBP and DBP). The asterisks indicate the level of the statistical significance of the difference between the two study groups (***P < 0.001; **P < 0.01; *P < 0.05).

Mentions: When indices were assessed separately for the awake and asleep periods, before adjustment, all of them were significantly different between the two groups for both the daytime and nighttime periods, with the exception of nighttime PWV (Figure 1(a)). After adjustment for confounding factors, only RWTT and central BP resulted systematically different between healthy subjects and hypertensive patients for both daytime and nighttime (Figure 1(b)). To note, all estimates of vascular health displayed a typical circadian rhythm: during night sleep RWTT and AI increased, while PWV and central BP decreased. Such a pattern was lost after correcting RWTT and aortic PWV by SBP and HR and peripheral AI by HR (normalized indices).


Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study.

Omboni S, Posokhov IN, Rogoza AN - Int J Hypertens (2015)

Daytime and nighttime reflected wave transit time (RWTT), aortic pulse wave velocity (PWV), peripheral and aortic augmentation index (AI), and central (aortic) systolic (SBP) and diastolic blood pressure (DBP) values in healthy controls (open bars) and hypertensive patients (gray bars). For RWTT, PWV, and AI not normalized and normalized data (corrected for SBP and/or heart rate) are represented. Data are shown as averages and 95% confidence intervals for crude estimates (a) and for adjusted estimates ((b) data adjusted by age, gender, body mass index, antihypertensive treatment, and 24-hour SBP and DBP). The asterisks indicate the level of the statistical significance of the difference between the two study groups (***P < 0.001; **P < 0.01; *P < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4321851&req=5

fig1: Daytime and nighttime reflected wave transit time (RWTT), aortic pulse wave velocity (PWV), peripheral and aortic augmentation index (AI), and central (aortic) systolic (SBP) and diastolic blood pressure (DBP) values in healthy controls (open bars) and hypertensive patients (gray bars). For RWTT, PWV, and AI not normalized and normalized data (corrected for SBP and/or heart rate) are represented. Data are shown as averages and 95% confidence intervals for crude estimates (a) and for adjusted estimates ((b) data adjusted by age, gender, body mass index, antihypertensive treatment, and 24-hour SBP and DBP). The asterisks indicate the level of the statistical significance of the difference between the two study groups (***P < 0.001; **P < 0.01; *P < 0.05).
Mentions: When indices were assessed separately for the awake and asleep periods, before adjustment, all of them were significantly different between the two groups for both the daytime and nighttime periods, with the exception of nighttime PWV (Figure 1(a)). After adjustment for confounding factors, only RWTT and central BP resulted systematically different between healthy subjects and hypertensive patients for both daytime and nighttime (Figure 1(b)). To note, all estimates of vascular health displayed a typical circadian rhythm: during night sleep RWTT and AI increased, while PWV and central BP decreased. Such a pattern was lost after correcting RWTT and aortic PWV by SBP and HR and peripheral AI by HR (normalized indices).

Bottom Line: Methods.After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Clinical Research Unit, Italian Institute of Telemedicine, 21048 Solbiate Arno, Italy.

ABSTRACT
Objective. Central blood pressure (BP) and vascular indices estimated noninvasively over the 24 hours were compared between normotensive volunteers and hypertensive patients by a pulse wave analysis of ambulatory blood pressure recordings. Methods. Digitalized waveforms obtained during each brachial oscillometric BP measurement were stored in the device memory and analyzed by the validated Vasotens technology. Averages for the 24 hours and for the awake and asleep subperiods were computed. Results. 142 normotensives and 661 hypertensives were evaluated. 24-hour central BP, pulse wave velocity (PWV), and augmentation index (AI) were significantly higher in the hypertensive group than in the normotensive group (119.3 versus 105.6 mmHg for systolic BP, 75.6 versus 72.3 mmHg for diastolic BP, 10.3 versus 10.0 m/sec for aortic PWV, -9.7 versus -40.7% for peripheral AI, and 24.7 versus 11.0% for aortic AI), whereas reflected wave transit time (RWTT) was significantly lower in hypertensive patients (126.6 versus 139.0 ms). After adjusting for confounding factors a statistically significant between-group difference was still observed for central BP, RWTT, and peripheral AI. All estimates displayed a typical circadian rhythm. Conclusions. Noninvasive assessment of 24-hour arterial stiffness and central hemodynamics in daily life dynamic conditions may help in assessing the arterial function impairment in hypertensive patients.

No MeSH data available.


Related in: MedlinePlus