Arterial stiffness assessed by pulse wave analysis in essential hypertension: relation to 24-h blood pressure profile.
BACKGROUND
Arterial stiffness is a risk factor for cardiovascular morbidity and mortality and appears to be increased in arterial hypertension. The purpose of the present study was to relate systemic arterial stiffness assessed by pulse wave analysis to variables of 24-h ambulatory blood pressure monitoring (ABPM) in patients with essential hypertension.


METHODS
Seventy-two subjects with untreated mild to moderate arterial hypertension underwent evaluation with 24-h ambulatory blood pressure monitoring. In the same subjects, applanation tonometry and pulse wave analysis was performed for evaluation of systemic arterial stiffness expressed as augmentation index and estimated aortic pulse wave velocity.


RESULTS
Clinic systolic blood pressure, mean heart rate during 24-h blood pressure monitoring and height were independent predictors of augmentation index and estimated aortic pulse wave velocity. The 41 patients with blunted reduction in nighttime blood pressure (nondippers) showed higher mean systolic blood pressure (p=0.02), lower systolic and diastolic blood pressure variability (p<0.001), higher pulse pressure during 24-h monitoring (p=0.05) and higher estimated aortic pulse wave velocity (p=0.03), indicating stiffer arteries in this group.


CONCLUSIONS
These results suggest that blood pressure change from day- to nighttime is an important determinant of arterial stiffness assessed by pulse wave analysis; this association could contribute to the higher cardiovascular risk in nondippers.
Lekakis
John P
JP
Department of Clinical Therapeutics, Alexandra University Hospital, 12 Iridanou Str. 11528 Athens, Greece. theopap@central.ntua.gr
Zakopoulos
Nikos A
NA
Protogerou
Athanasios D
AD
Papaioannou
Theodoros G
TG
Kotsis
Vassilios Th
VT
Pitiriga
Vassiliki Ch
VCh
Tsitsirikos
Marios D
MD
Stamatelopoulos
Kimon S
KS
Papamichael
Christos M
CM
Mavrikakis
Myron E
ME
D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011674:Pulse; D017534:Radial Artery / Q000503:physiopathology*; D013997:Time Factors; D014652:Vascular Diseases / Q000503:physiopathology; D014655:Vascular Resistance / Q000502:physiology*