title: Modification over time of pulse wave velocity parallel to changes in aortic BP, as well as in 24-h ambulatory brachial BP.
abstract: Arterial stiffness as assessed by carotid-femoral pulse wave velocity (cfPWV) is a marker of preclinical organ damage and a predictor of cardiovascular outcomes, independently of blood pressure (BP). However, limited evidence exists on the association between long-term variation (Δ) on aortic BP (aoBP) and ΔcfPWV. We aimed to evaluate the relationship of ΔBP with ΔcfPWV over time, as assessed by office and 24-h ambulatory peripheral BP, and aoBP. AoBP and cfPWV were evaluated in 209 hypertensive patients with either diabetes or metabolic syndrome by applanation tonometry (Sphygmocor) at baseline(b) and at 12 months of follow-up(fu). Peripheral BP was also determined by using validated oscillometric devices (office(o)-BP) and on an outpatient basis by using a validated (Spacelabs-90207) device (24-h ambulatory BP). ΔcfPWV over time was calculated as follows: ΔcfPWV=[(cfPWVfu-cfPWVb)/cfPWVb] × 100. ΔBP over time resulted from the same formula applied to BP values obtained with the three different measurement techniques. Correlations (Spearman 'Rho') between ΔBP and ΔcfPWV were calculated. Mean age was 62 years, 39% were female and 80% had type 2 diabetes. Baseline office brachial BP (mm Hg) was 143±20/82±12. Follow-up (12 months later) office brachial BP (mm Hg) was 136±20/79±12. ΔcfPWV correlated with ΔoSBP (Rho=0.212; P=0.002), Δ24-h SBP (Rho=0.254; P<0.001), Δdaytime SBP (Rho=0.232; P=0.001), Δnighttime SBP (Rho=0.320; P<0.001) and ΔaoSBP (Rho=0.320; P<0.001). A multiple linear regression analysis included the following independent variables: ΔoSBP, Δ24-h SBP, Δdaytime SBP, Δnighttime SBP and ΔaoSBP. ΔcfPWV was independently associated with Δ24-h SBP (β-coefficient=0.195; P=0.012) and ΔaoSBP (β-coefficient= 0.185; P=0.018). We conclude that changes in both 24-h SBP and aoSBP more accurately reflect changes in arterial stiffness than do office BP measurements.
authors.affiliation: Hypertension Unit, Department of Nephrology, Hospital Universitari del Mar, Barcelona, Spain.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Oliveras
authors.affiliation: Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: J
authors.identifier: http://orcid.org/0000-0003-4677-9526
authors.initials: J
authors.lastname: Segura
authors.affiliation: Department of Internal Medicine, Hospital La Princesa, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Suarez
authors.affiliation: Health Center La Alamedilla, IBSAL (Institute of Biomedical Research of Salamanca), Salamanca, Spain.
authors.forename: L
authors.initials: L
authors.lastname: García-Ortiz
authors.affiliation: Hypertension Unit, Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Abad-Cardiel
authors.affiliation: Hospital de Móstoles, Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Vigil
authors.affiliation: Health Center La Alamedilla, IBSAL (Institute of Biomedical Research of Salamanca), Salamanca, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Gómez-Marcos
authors.affiliation: Hypertension Unit, Department of Nephrology, Hospital Universitari del Mar, Barcelona, Spain.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Sans Atxer
authors.affiliation: Hypertension Unit, Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Martell-Claros
authors.affiliation: Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: L M
authors.initials: LM
authors.lastname: Ruilope
authors.affiliation: Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: de la Sierra
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness