Association of changes in ambulatory arterial stiffness index and pulse wave velocity during antihypertensive treatment: the J-CORE study.
BACKGROUND
We aimed to investigate the association of the change in the ambulatory arterial stiffness index (AASI) with that in carotid-femoral pulse wave velocity (cfPWV) during treatment with antihypertensive medication.


METHODS
We enrolled 207 hypertensive patients treated with olmesartan monotherapy for 12 weeks. Patients were randomly assigned to treatment with hydrochlorothiazide (HCTZ; n = 104) or azelnidipine (n = 103) for 24 weeks. The cfPWV and 24-h ambulatory blood pressure monitoring (ABPM) results were assessed at baseline and 24 weeks later. The AASI was defined as 1 minus the regression slope of diastolic blood pressure (DBP) on systolic BP (SBP), and was calculated by standard and symmetric regression.


RESULTS
The changes in the AASI and symmetrical AASI were similar between the two groups, while cfPWV in the azelnidipine group decreased more than in the HCTZ group (P < 0.001). The change in AASI was not significantly correlated with change in cfPWV (r = 0.08, P = 0.26), whereas the change in symmetrical AASI was significantly but weakly correlated with change in cfPWV (r = 0.22, P < 0.001). The multivariable linear regression analysis revealed that the association of the change in symmetrical AASI with change in cfPWV remained significant even after adjustments for covariates derived from ABPM (regression coefficient (95% confidence interval): 1.33 (0.35-2.30), P = 0.01).


CONCLUSIONS
The present study demonstrated that neither AASI nor symmetrical AASI may be an unequivocal marker of arterial stiffness during antihypertensive treatment.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan. yoshio@jichi.ac.jp
Yoshio
Y
Matsui
Michael F
MF
O'Rourke
Joji
J
Ishikawa
Kazuyuki
K
Shimada
Kazuomi
K
Kario
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001383:Azetidinecarboxylic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D004095:Dihydropyridines / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D007093:Imidazoles / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D013777:Tetrazoles / Q000627:therapeutic use; D059289:Vascular Stiffness / Q000187:drug effects
D000959:Antihypertensive Agents; D004095:Dihydropyridines; D007093:Imidazoles; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D001383:Azetidinecarboxylic Acid; C437965:olmesartan; C061679:azelnidipine