Ambulatory arterial stiffness index predicts stroke in a general population.
OBJECTIVE
The ambulatory arterial stiffness index (AASI) can be computed from individual 24-h blood pressure recordings.


METHODS
We investigated the prognostic value of AASI and 24-h pulse pressure in a random sample of 1829 Danes, aged 40-70 years. We adjusted for sex, age, body mass index, mean arterial pressure, smoking, diabetes, ratio of total to high-density lipoprotein cholesterol, and history of cardiovascular disease with Cox regression.


RESULTS
Over a median follow-up of 9.4 years, incidences of fatal and nonfatal endpoints were 40 for stroke, 150 for coronary heart disease, and 212 for cardiovascular events. In fully adjusted models, the hazard ratios associated with 1 SD increase (0.14 U) in the AASI were 1.62 (95% confidence interval, 1.14-2.28; P = 0.007) for stroke, 0.96 (0.80-1.14; P = 0.62) for coronary heart disease, and 1.06 (0.91-1.23; P = 0.49) for cardiovascular events. None of these ratios reached significance for pulse pressure (P > 0.47). The AASI still predicted stroke after excluding individuals with previous cardiovascular disease or after adjustment for systolic and/or diastolic blood pressure instead of mean arterial pressure.


CONCLUSIONS
In a randomly recruited European population, the AASI was a strong predictor of stroke, beyond traditional cardiovascular risk factors, including the mean arterial pressure and pulse pressure.
Hansen
Tine W
TW
Research Center for Prevention and Health, Copenhagen, Denmark. tw@heart.dk
Staessen
Jan A
JA
Torp-Pedersen
Christian
C
Rasmussen
Susanne
S
Li
Yan
Y
Dolan
Eamon
E
Thijs
Lutgarde
L
Wang
Ji-Guang
JG
O'Brien
Eoin
E
Ibsen
Hans
H
Jeppesen
Jørgen
J
D000328:Adult; D001158:Arteries; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*