Association of target organ damage with three arterial stiffness indexes according to blood pressure dipping status in untreated hypertensive patients.
BACKGROUND
Subclinical organ damage represents an intermediate stage in the continuum of vascular disease and a determinant of overall cardiovascular risk. We investigated the associations of pulse wave velocity (PWV), ambulatory arterial stiffness index (AASI), and office pulse pressure (PP) with several target organ damages (TODs) in newly diagnosed and never-treated patients with essential hypertension with respect to their dipping profile.


METHODS
One hundred sixty-eight hypertensive patients with recently diagnosed and never-treated stage I-II essential hypertension were evaluated with respect to the relationship of PWV, AASI, and office PP with TOD including microalbumin (MAU) levels, cognitive function, intima-media thickness (IMT), coronary flow reserve (CFR), left ventricular mass (LVM), left ventricular filling pressures, diastolic dysfunction, and left atrium (LA) enlargement.


RESULTS
Simultaneous estimation of AASI, PWV, and office PP independently associated with the following: (i) CFR (P < 0.01), 24-h urine albumin excretion rates (P < 0.05), left ventricular diastolic dysfunction (P < 0.01), and LA enlargement (P < 0.01) in never-treated hypertensive patients; (ii) CFR (P < 0.05), IMT (P < 0.01), left ventricular diastolic dysfunction (P < 0.05), and LA enlargement (P < 0.05) in dippers; and (iii) CFR (P < 0.05) and LA enlargement (P < 0.01) in nondippers. Nonindependent relationships revealed between (i) AASI and left ventricular filling pressures and (ii) PWV and cognitive dysfunction in never-treated hypertensive patients.


CONCLUSIONS
The simultaneous estimation of three noninvasive indexes of arterial stiffness leads to valuable information regarding their association with TOD including CFR, MAU levels, IMT, left ventricular diastolic dysfunction, and LA enlargement in never-treated hypertensive patients regarding their dipping status.
Triantafyllidi
Helen
H
2nd Department of Cardiology, Attikon Hospital, Medical School, University of Athens, Athens, Greece. seliani@hotmail.com
Tzortzis
Stavros
S
Lekakis
John
J
Ikonomidis
Ignatios
I
Arvaniti
Chrysa
C
Trivilou
Paraskevi
P
Kontsas
Konstantinos
K
Siafakas
Nikolaos
N
Zerva
Loukia
L
Stamboulis
Eleftherios
E
Kremastinos
Dimitrios
D
Anastasiou-Nana
Maria
M
D000328:Adult; D000368:Aged; D001158:Arteries / Q000503:physiopathology; D001783:Blood Flow Velocity; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D011674:Pulse; D012306:Risk; D014655:Vascular Resistance