Giuseppe Schillaci; Gianfranco Parati; Matteo Pirro; Giacomo Pucci; Massimo R. Mannarino; Laura Sperandini; Elmo Mannarino
From the Unit of Internal Medicine (G.S., M.P., G.Pucci, M.R.M., L.S., E.M.), Angiology and Arteriosclerosis, University of Perugia, Perugia, Italy; the Department of Clinical Medicine and Prevention (G.Parati), University of Milano-Bicocca, Milan, Italy; and the Department of Cardiology (G.Parati), San Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy
Ambulatory arterial stiffness index (AASI), a measure based on the relative behavior of 24-hour systolic and diastolic blood pressure (BP), has been suggested as a marker of arterial stiffness and a predictor of cardiovascular mortality.
However, a narrow range of diastolic BP values over the 24 hours tends to flatten the regression slope and to artificially increase AASI. We explored the possible influence of different ranges of 24-hour diastolic BP fluctuations, such as those related to nocturnal BP fall, on AASI, and on its relationship with target organ damage. In 515 untreated hypertensive patients, AASI was directly related to age (r=0.30) and 24-hour systolic BP (r=0.20), whereas it was inversely related with nocturnal systolic and diastolic BP reduction (r=–0.28 and –0.46, respectively; all P<0.001). r="0.17;" r="0.28;">
Our conclusions are as follows: (1) AASI is strongly dependent on the degree of nocturnal BP fall in hypertensive patients; (2) there is no significant relation between AASI and left ventricular mass after proper adjustment for confounders; and (3) the relation between AASI and a widely accepted measure of aortic stiffness, such as pulse wave velocity, is weak and importantly affected by other factors.
Key Words: ambulatory blood pressure monitoring • arteries • blood pressure • arterial stiffness • left ventricular hypertrophy
Hypertension. 2007;49:986.
Hypertension. 2007;49:986.
© 2007 American Heart Association, Inc.
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