Key result
In middle-aged Indian hypertensive patients, 24-hour average pulse pressure showed the strongest correlation with arterial stiffness assessed by carotid-femoral pulse wave velocity (r=0.414, p=0.003).
Why the study?
The study was conducted to identify the predominant determinants of arterial stiffness assessed by pulse-wave velocity among various 24-hour ambulatory blood pressure monitoring parameters in Indian hypertensive subjects.
Cross-Sectional (n=51)
In middle-aged hypertensive patients, 24-hour average pulse pressure is the strongest ambulatory blood pressure determinant of arterial stiffness, suggesting pulsatile blood pressure impacts aortic stiffness more than continuous blood pressure.
Answers are grounded in this paper and cite their sources.
May aid stiffness evaluation in hypertensives; hypothesis-generating and should not change practice.
Objective The objective of the study is to identify the predominant determinants of arterial stiffness as assessed by pulse-wave-velocity (PVW) amongst various 24-hour ambulatory blood pressure monitoring (ABPM) parameters in Indian hypertensive subjects. Method Subjects of both genders between 18-60 years with hypertension and who were either drug naïve or on stable anti-hypertensive treatment for at least three months were included in the study. All subjects underwent clinical evaluation with a medical history, biochemical investigations, and assessment of arterial stiffness by PWV along with 24-hour ABPM. Results We found the males were younger than females amongst hypertensive cohort (41.53 ± 10.89 years vs. 52.2 ± 5.17 years, respectively; p=0.001) and had shorter duration of hypertension (41.42 ± 49.14 months vs. 87.8 ± 74.55 months, respectively; p=0.012) and had lower 24-hour average pulse pressure (aPP; 49.1 ± 7.8 mm Hg vs. 57.83 ± 8.92 mm Hg, respectively; p=0.001) at baseline. Younger people (<40-years) as compared to those >40-years of age had the lower carotid-femoral (cf) PWV (972.8 ± 125.0 cm/sec vs. 1165.0 ± 208.4 cm/sec, respectively; p=0.001) and average brachial-ankle (ba) PWV (1413.7 ± 160.4 cm/sec and 1640.0 ± 227.1 cm/sec, respectively; p=0.001). Bivariate analysis revealed that amongst all the 24-hour ABPM parameters, 24-hour aPP had the strongest correlation (r=0.414, p=0.003) with arterial stiffness as assessed by PWV. Also, statistically significant correlation was found in age group <40 years between cf-PWV and both 24-hour aPP (r=0.54, p=0.025) as well as night-time aPP (r=0.59, p=0.013) Conclusion We conclude that 24-hour aPP showed the strongest correlation with arterial stiffness parameters and best correlated with arterial stiffness variables amongst 24-hour ABPM parameters, especially amongst subjects <40 years of age. The pulsatile blood pressure (BP) was a better predictor of aortic PWV than the continuous part of BP.
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Bhandari et al. (2020) conducted a cross-sectional in Essential hypertension (n=51). 24-hour ambulatory blood pressure monitoring was evaluated on Correlation between 24-hour average pulse pressure and carotid-femoral pulse wave velocity (cf-PWV) (r=0.414, p=0.003). In middle-aged Indian hypertensive patients, 24-hour average pulse pressure showed the strongest correlation with arterial stiffness assessed by carotid-femoral pulse wave velocity (r=0.414, p=0.003).
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