Ambulatory Arterial Stiffness Index as Predictor Subclinical Target Organ Damage in Hypertensive Patients: Pp.25.10

Background: Increased arterial stiffness has been shown to predict cardiovascular risk in hypertensive patients. The objective is to evaluate the relationship between the ambulatory arterial stiffness index (AASI) and subclinical organ damage (SOD). Methods: Design: Cross sectional study. Subjects: 554 hypertensive patients with and without drug treatment (mean age 57 ± 12 years, 60.6% males). Measurement: Ambulatory arterial stiffness index was defined as 1 minus the regression slope of diastolic over systolic BP readings obtained from 24-hour recordings. Renal damage was evaluated on the basis of glomerular filtration rate (GFR) and microalbuminuria; vascular damage according to carotid intima-media thickness (IMT) and ankle/arm index; and cardiac damage on the basis of the Cornell voltage-duration product (Cornell VDP) and left ventricular mass index. Results: The mean AASI was 0.38 ± 0.07 (0.39 ± 0.07 in treated patients and 0.37 ± 0.06 in non-treated subjects). The index showed a positive correlation to IMT (r = 0.417, p < 0.001) and Cornell VDP (r = 0.188, p < 0.001), and a negative correlation to the Cockroft-Gault formula (r = -0.205, p = 0.001) and ankle/arm index. The variables associated to the presence of SOD were AASI (OR = 3.89) and smoking (OR = 1.55). The variables associated to IMT were smoking and waist circumference, while those associated to GFR were AASI, body mass index and waist circumference. In turn, smoking, total cholesterol and HbA1c were the variables associated to the ankle/arm index. Conclusion: The increased AASI implies a greater presence of SOD in primary hypertensive patients with or without blood pressure-lowering drug treatment.