title: Ambulatory arterial stiffness index and renal abnormalities in primary hypertension.
abstract: OBJECTIVE
  Arterial stiffness is a predictor of cardiovascular mortality in the general population as well as in hypertension and end-stage renal disease. We investigated the relationship between a recently proposed ambulatory blood pressure monitoring-derived index of arterial stiffness and early signs of renal damage in patients with primary hypertension.
  
  
  METHODS
  A total of 168 untreated patients with sustained primary hypertension were studied. Ambulatory arterial stiffness index (AASI) was calculated based on 24-h ambulatory blood pressure readings. Albuminuria was measured as the albumin to creatinine ratio. Creatinine clearance was estimated using the Cockcroft-Gault formula, and the interlobar resistive index was evaluated by renal ultrasound and Doppler examination.
  
  
  RESULTS
  AASI was positively related to urinary albumin excretion and resistive index, and was negatively related to estimated creatinine clearance and renal volume to the resistive index ratio. Patients with AASI above the median (i.e. > 0.51) showed a higher prevalence of microalbuminuria and a mild reduction in creatinine clearance. Moreover, patients with microalbuminuria or a mild reduction in creatinine clearance had significantly higher AASI values compared with those without, and the greater the renal involvement, the greater the AASI. After adjusting for several potentially confounding variables, we found that each standard deviation increase in AASI (i.e. 0.16) entails an almost twofold greater risk of renal involvement.
  
  
  CONCLUSIONS
  Increased AASI is independently associated with early signs of renal damage in patients with sustained primary hypertension. These results strengthen the usefulness of AASI and ambulatory blood pressure monitoring in cardiovascular risk assessment.
authors.affiliation: Department of Cardio-Nephrology, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Ratto
authors.forename: Giovanna
authors.initials: G
authors.lastname: Leoncini
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.forename: Valentina
authors.initials: V
authors.lastname: Vaccaro
authors.forename: Valeria
authors.initials: V
authors.lastname: Falqui
authors.forename: Angelica
authors.initials: A
authors.lastname: Parodi
authors.forename: Novella
authors.initials: N
authors.lastname: Conti
authors.forename: Cinzia
authors.initials: C
authors.lastname: Tomolillo
authors.forename: Giacomo
authors.initials: G
authors.lastname: Deferrari
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontremoli
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000209:etiology* / Q000503:physiopathology; D001158:Arteries / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D004548:Elasticity; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology*; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D014655:Vascular Resistance / Q000502:physiology