title: The Use of the Ambulatory Arterial Stiffness Index in Patients Suspected of Secondary Hypertension.
abstract: The ambulatory arterial stiffness index (AASI) is a marker of arterial stiffness and is derived from ambulatory 24-h blood pressure registration. We studied whether the AASI could be used as a predictive factor for the presence of renal artery stenosis (RAS) in patients with a suspicion of secondary hypertension and as such as a diagnostic tool for RAS. We included 169 patients with difficult-to-treat hypertension. They all underwent 24-h ambulatory blood pressure monitoring registration, imaging of the renal arteries, and cardiovascular risk measurement, including smoking, history, biometrics, blood pressure, renal function, lipids, and glucose metabolism. Performing univariate and multivariate analyses, we investigated if AASI and the other cardiovascular risk factors were related to the presence of RAS. Of the 169 patients (49% women), 31% had RAS. The mean AASI was 0.44 (0.16). The presence of RAS showed no significant correlation with AASI (r= 0.14,P= 0.06). Age (r= 0.19,P= 0.01), hypercholesterolemia (r= 0.26,P= 0.001), history of CVD (r= 0.22,P= 0.004), and creatinine clearance (r= -0.34,P< 0.001) all demonstrated a correlation with RAS. Although AASI is higher in patients with RAS, AASI does not independently predict the presence of RAS in hypertensive subjects.
authors.affiliation: Division of Vascular Medicine, Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Department of Cardiology, Isala Hospital, Zwolle, Netherlands.
authors.forename: Joshua R A
authors.initials: JR
authors.lastname: Verbakel
authors.affiliation: Department of Cardiology, Isala Hospital , Zwolle , Netherlands.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Adiyaman
authors.affiliation: Division of Vascular Medicine, Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Rijnstate Hospital, Arnhem, Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kraayvanger
authors.affiliation: Department of Cardiovascular Medicine, University Hospital of Münster , Münster , Germany.
authors.forename: Dirk G
authors.initials: DG
authors.lastname: Dechering
authors.affiliation: Division of Vascular Medicine, Department of Internal Medicine, Radboud University Nijmegen Medical Centre , Nijmegen , Netherlands.
authors.forename: Cornelis T
authors.initials: CT
authors.lastname: Postma
keywords: arterial stiffness; atherosclerosis; diagnosis; differential; difficult-to-treat hypertension; hypertension; renal artery; secondary hypertension