title: Association between home arterial stiffness index and target organ damage in hypertension: comparison with pulse wave velocity and augmentation index.
abstract: OBJECTIVE
  To clarify the implications of the home arterial stiffness index (HASI), we compared HASI with other arterial stiffness measures and investigated the association between HASI and hypertensive target organ damage (TOD).
  
  
  METHODS
  We assessed brachial-ankle pulse wave velocity (baPWV) and the carotid augmentation index (cAIx) as measures of arterial stiffness and wave reflection, and the left ventricular mass index (LVMI), carotid intima-media thickness (IMT) using ultrasonography, and the urinary albumin/creatinine ratio (UACR) as measures of TOD in 356 never-treated hypertensive subjects. Home blood pressure (BP) was taken in triplicate in the morning and evening, respectively, for 14 consecutive days with a memory-equipped device. HASI was defined as 1 minus the respective regression slope of diastolic on systolic BP.
  
  
  RESULTS
  HASI was significantly correlated with age (r = 0.32, P < 0.001), home pulse pressure (r = 0.36, P < 0.001), morning-evening difference in home systolic BP (r = -0.29, P < 0.001), baPWV (r = 0.18, P < 0.001), cAIx (r = 0.16, P = 0.002), carotid IMT (r = 0.26, P < 0.001), and UACR (r = 0.24, P < 0.001), but not with LVMI (r = 0.05, P = 0.38). After adjustment for age and sex, the significant correlation between HASI and baPWV/cAIx was lost. In multivariate regression analyses, HASI and baPWV were significantly associated with carotid IMT (standardized β = 0.21, P<0.001; β = 0.14, P = 0.014) and UACR (β = 0.13, P = 0.018; β = 0.21, P < 0.001), independently of age, sex, and home mean arterial pressure. On the other hand, cAIx was independently associated only with LVMI (β = 0.24, P < 0.001).
  
  
  CONCLUSIONS
  These findings indicate that HASI adds nothing to the existing measures of arterial stiffness, but might be a BP component that can aid in the detection of carotid atherosclerosis and renal damage, similar to PWV.
authors: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. yoshio@jichi.ac.jp
authors: Yoshio
authors: Y
authors: Matsui
authors: Joji
authors: J
authors: Ishikawa
authors: Seiichi
authors: S
authors: Shibasaki
authors: Kazuyuki
authors: K
authors: Shimada
authors: Kazuomi
authors: K
authors: Kario
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology / Q000652:urine; D000704:Analysis of Variance; D055109:Ankle Brachial Index; D001158:Arteries / Q000503:physiopathology*; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D003187:Compliance; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D007564:Japan; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011673:Pulsatile Flow; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D003404:Creatinine