title: Ambulatory arterial stiffness indices and target organ damage in hypertension.
abstract: BACKGROUND
  The present study was designed to evaluate which arterial stiffness parameter - AASI or the home arterial stiffness index (HASI) - correlates best with vascular, cardiac and renal damage in hypertensive individuals.
  
  
  METHODS
  A cross-sectional study was carried out involving 258 hypertensive patients. AASI and HASI were defined as the 1-regression slope of diastolic over systolic blood pressure readings obtained from 24-hour recordings and home blood pressure over 6 days. Renal damage was evaluated by glomerular filtration rate (GFR) and microalbuminuria; vascular damage by carotid intima-media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index (ABI); and left ventricular hypertrophy by the Cornell voltage-duration product (VDP) and the Novacode index.
  
  
  RESULTS
  AASI and HASI were not correlated with microalbuminuria, however AASI and HASI- blood pressure variability ratio (BPVR) showed negative correlation with GRF. The Cornell PDV was positively correlated with AASI- BPVR-Sleep (r = 0.15, p < 0.05) and the left ventricular mass index with HASI-BPVR (r = 0.19, p < 0.01). Carotid IMT and PWV were positively correlated with all the parameters except the HASI, while ABI was negatively correlated with AASI and Awake-AASI. After adjusting for age, gender and 24 hours heart rate, statistical significance remains of the IMT with AASI, Awake AASI and AASI-BPVR. PWV with the AASI, Awake-AASI and Sleep-AASI. ABI with AASI and Awake-AASI. Odd Ratio to presence target organ damage was for AASI: 10.47(IC95% 1.29 to 65.34), Awake-AASI: 8.85(IC95% 1.10 to 71.04), Sleep-AASI: 2.19(IC95% 1.10 to 4.38) and AASI-BPVR-night: 4.09 (IC95% 1.12 to 14.92).
  
  
  CONCLUSIONS
  After adjusting for age, gender and 24-hour heart, the variables that best associated with the variability of IMT, PWV and ABI were AASI and Awake-AASI, and with GFR was HASI-BPVR.
authors.affiliation: Primary Care Research Unit, La Alamedilla Health Centre, Salamanca, Spain, REDIAPP. magomez@usal.es
authors.forename: Manuel Angel
authors.initials: MA
authors.lastname: Gómez-Marcos
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Recio-Rodríguez
authors.forename: Ma Carmen
authors.initials: MC
authors.lastname: Patino-Alonso
authors.forename: Leticia
authors.initials: L
authors.lastname: Gómez-Sánchez
authors.forename: Cristina
authors.initials: C
authors.lastname: Agudo-Conde
authors.forename: Marta
authors.initials: M
authors.lastname: Gómez-Sánchez
authors.forename: Emiliano
authors.initials: E
authors.lastname: Rodríguez-Sánchez
authors.forename: Luís
authors.initials: L
authors.lastname: García-Ortiz
mesh_terms: D000419:Albuminuria / Q000150:complications; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D008297:Male; D008875:Middle Aged; D059289:Vascular Stiffness / Q000502:physiology*