title: Cystatin C is better than albuminuria as a predictor of pulse wave velocity in hypertensive patients.
abstract: BACKGROUND
  Arterial stiffness is important in the evaluation of the cardiovascular risk in both general population and hypertensive patients. In this study, we aimed to investigate the associations of both serum cystatin C levels and albuminuria with arterial stiffness in healthy controls and hypertensive patients.
  
  
  METHODS
  Seventy-six healthy controls (male/female = 44/32) and 76 hypertensive patients (male/female = 43/33) were enrolled. Arterial stiffness parameters such as augmentation index (AIx) and pulse wave velocity (PWV) were non-invasively measured with the Arteriograph (Tensiomed Ltd., Budapest, Hungary).
  
  
  RESULTS
  AIx (31.92 ± 14.31 vs. 27.95 ± 11.03, p = 0.03) and PWV (9.84 ± 1.62 vs. 8.87 ± 2.04, p < 0.001) were significantly higher in hypertensive patients compared to healthy controls. Patients with microalbuminuria had significantly higher AIx (43.47 ± 9.91 vs. 30.37 ± 14.13, p = 0.002) and higher serum cystatin C levels [0.76 (0.67-0.95) vs. 0.68 (0.62-0.78) mg/L, p = 0.03]. In the hypertensive group, AIx was significantly correlated with PWV (r = 0.519, p < 0.001), glomerular filtration rate (cystatin C) (r = -0.438, p = 0.003), mean arterial pressure (MAP) (r = 0.288, p = 0.015) and urinary albumin-creatinine ratio (ACR) (r = 0.386, p = 0.004). PWV was associated with serum cystatin C (r = 0.442, p = 0.003) and MAP (r = 0.377, p = 0.001). In the linear regression analysis (model r = 0.577, p = 0.006) for the prediction of PWV in hypertensive patients, MAP, urinary ACR, age and serum cystatin C levels were included as independent variables. Cystatin C was found to be the significant determinant of PWV in hypertensive patients.
  
  
  CONCLUSIONS
  Multivariate analysis revealed that serum cystatin C but not albuminuria was significantly associated with PWV in hypertensive patients. Serum cystatin C may be better than albuminuria as a predictor of arterial stiffness in hypertensive patients.
authors.affiliation: Department of Internal Medicine and Nephrology, Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey .
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ozkok
authors.forename: Timur Selcuk
authors.initials: TS
authors.lastname: Akpinar
authors.forename: Fatih
authors.initials: F
authors.lastname: Tufan
authors.forename: Omer
authors.initials: O
authors.lastname: Kaya
authors.forename: Hamza Ugur
authors.initials: HU
authors.lastname: Bozbey
authors.forename: Riza
authors.initials: R
authors.lastname: Atas
authors.forename: Bahtiyar
authors.initials: B
authors.lastname: Toz
authors.forename: Kadri
authors.initials: K
authors.lastname: Atay
authors.forename: Emre
authors.initials: E
authors.lastname: Yilmaz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Besiroglu
authors.forename: Kamil
authors.initials: K
authors.lastname: Nas
authors.forename: Nur
authors.initials: N
authors.lastname: Hadrovic
authors.forename: Miklós
authors.initials: M
authors.lastname: Illyés
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ecder
mesh_terms: D000419:Albuminuria / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology*; D001794:Blood Pressure; D055316:Cystatin C / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D055316:Cystatin C
keywords: Albuminuria; arterial stiffness; augmentation index; chronic kidney disease; cystatin C; hypertension; pulse wave velocity