scholarly journals Ambulatory Arterial Stiffness Index Is Higher in Hypertensive Patients with Chronic Kidney Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ronaldo Altenburg Gismondi ◽  
Mario Fritsch Neves ◽  
Wille Oigman ◽  
Rachel Bregman

Ambulatory arterial stiffness index (AASI) is a parameter obtained from ambulatory blood pressure monitoring (ABPM) that correlates with clinical endpoints. The aim of this study was to compare AASI in nondiabetic hypertensive patients with and without chronic kidney disease (CKD). Subjects with systemic arterial hypertension (SAH,n=30) with normal renal function, aged 40 to 75 years, were compared to hypertensive patients with CKD (n=30) presenting estimated glomerular filtration rate (eGFR) <60 mL/min by MDRD formula. ABPM was carried out in all patients. In CKD group, eGFR was 35.3 ± 2.8 ml/min. The mean 24-hour systolic and diastolic blood pressure (BP) was similar in both groups. AASI was significantly higher in CKD group (0.45±0.03versus0.37±0.02,P<0.05), positively correlated to age (r=0.38,P<0.01) and pulse pressure (r=0.43,P<0.01) and negatively correlated to nocturnal BP fall (r=-0.28,P=0.03). These findings indicate the presence of stiffer vessels in CKD hypertensive patients.

2017 ◽  
Vol 64 (4) ◽  
pp. 279-283
Author(s):  
Alexandru Minca ◽  
◽  
Mihai Comsa ◽  
Maria Mirabela Manea ◽  
Maria Daniela Tanasescu ◽  
...  

Chronic kidney disease (CKD) affects approximately two million people (in a population of 20 million) in Romania. Hypertension is often associated with CKD and both (hypertension and CKD) are risk factors for cardiovascular (CV) events. Ambulatory blood pressure monitoring (ABPM) is increasingly used all around the world for the diagnosis and monitoring of BP (blood pressure) because it is proven that the ABPM is superior to office BP measurements in evaluating patients with hypertension, with or without CKD. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR). Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). It has prognostic value for cardiac death and stroke and several studies have showed that is negatively related to eGFR and is positively related to albuminuria. Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function. These facts suggest that ABPM offers multiple useful data with impact, not only in future CV and renal outcomes assessment, but also in the treatment and management of hypertensive patients with CKD.


2020 ◽  
Vol 71 (7) ◽  
pp. 425-435
Author(s):  
Teim Baaj ◽  
Ahmed Abu-Awwad ◽  
Mircea Botoca ◽  
Octavian Marius Cretu ◽  
Elena Ardeleanu ◽  
...  

Accelerated atherosclerosis and cardiovascular diseases are frequent complications in hypertensive patients with chronic kidney disease (CKD), being mainly driven by cardiovascular risk factors as lipid disorders and an unfavorable blood pressure profile. The objectives of the study were to evaluate the lipid profile and to assess the characteristics of blood pressure (BP) in patients with primary arterial hypertension associating chronic kidney disease (CKD) in a primary care population in Timis County, Romania. Lipid disorders were highly prevalent in hypertensive patients with CKD, consisting in hyper LDL-cholesterolemia in 50.3%, hypertriglyceridemia in 52%, low HDL-cholesterol levels in 35.8%. More than 2 lipid abnormalities were present in 68.8% of CKD hypertensive. CKD hypertensive patients, compared with those without CKD, presented a BP profile with higher systolic and diastolic office BP. On ambulatory blood pressure monitoring they also registred higher systolic and diastolic BP, the systolic BP (SBP), both for 24 h SBP, day-time and night-time SBP being statistically significant higher than in hypertensive patients without CKD. The circadian 24 h BP profile demonstrated in the CKD hypertensive population an unfavourable nocturnal profile in 67%, consisting of a high prevalence of the non-dipping profile and of nocturnal riser pattern.


2019 ◽  
Vol 20 (21) ◽  
pp. 5301 ◽  
Author(s):  
Hsu ◽  
Lu ◽  
Lo ◽  
Lin ◽  
Tain

Cardiovascular disease (CVD) is common in chronic kidney disease (CKD), while major CV events are rare in young CKD patients. In addition to nitric oxide (NO)-related biomarkers, several surrogate markers have been assessed to stratify CV risk in youth with CKD, including 24-h ambulatory blood pressure monitoring (ABPM), carotid artery intima-media thickness (cIMT), pulse wave velocity (PWV), ABPM-derived arterial stiffness index (AASI), flow-mediated dilatation (FMD), and left ventricular mass index (LVMI). The aim of this study was to identify subclinical CVD through the analysis of indices of CV risk in children and adolescents with CKD. Between 2016 and 2018, the prospective observational study enrolled 125 patients aged 3 to 18 years with G1–G4 CKD stages. Close to two-thirds of young patients with CKD exhibited blood pressure (BP) abnormalities on ABPM. CKD children with abnormal office BP showed lower plasma arginine levels and arginine-to-asymmetric dimethylarginine (ADMA) ratio, but higher ratios of ADMA-to-symmetric dimethylarginine (SDMA) and citrulline-to-arginine. High PWV and AASI, indices of arterial stiffness, both strongly correlated with high BP load. Additionally, LV mass and LVMI exhibited strong correlations with high BP load. Using an adjusted regression model, we observed the citrulline-to-arginine ratio was associated with 24-h systolic and diastolic BP, systolic blood pressure (SBP) load, and diastolic blood pressure (DBP) load. Early assessments of NO-related parameters, BP load abnormalities, arterial stiffness indices, and LV mass will aid in early preventative care toward decreasing CV risk later in life for children and adolescents with CKD.


2012 ◽  
Vol 166 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Francesca Dassie ◽  
Andrea Grillo ◽  
Renzo Carretta ◽  
Bruno Fabris ◽  
Loredana Macaluso ◽  
...  

ObjectiveAcromegaly is associated with increased cardiovascular morbidity and mortality and with specific heart and vascular abnormalities. The aim of our study was to investigate arterial stiffness using the ambulatory arterial stiffness index (AASI) and symmetric AASI (Sym-AASI), two indexes derived from 24-h ambulatory blood pressure monitoring (ABPM), in a group of normotensive and hypertensive patients with active acromegaly, compared with normotensive controls (NOR-CTR) or hypertensive controls (HYP-CTR).Subjects and methodsNinety-six consecutive patients with active acromegaly (46 males, mean age 49±14 years) underwent 24-h ABPM and evaluation of cardiovascular risk factors. Based on ABPM measurement, acromegalic patients were divided into 64 normotensive (normotensive acromegalic patients (NOR-ACRO)) and 32 hypertensive (hypertensive acromegalic patients (HYP-ACRO)) patients, and were compared with 35 normotensive (NOR-CTR) and 34 hypertensive (HYP-CTR) age-, sex,- and ABPM-matched control subjects.ResultsThe AASI and Sym-AASI indexes were significantly higher in acromegalic patients than in controls, either in the normotensive (NOR-ACRO vs NOR-CTR, P<0.0001 for AASI and P=0.005 for Sym-AASI) or in the hypertensive (HYP-ACRO vs HYP-CTR, P=0.01 for AASI and P=0.01 for Sym-AASI) group. Multiple logistic regression analysis showed a significant association of the highest AASI tertile with serum IGF1 (P=0.034) in the whole acromegalic group.ConclusionAASIs are increased in acromegaly, independent of blood pressure (BP) elevation, and may have an important role in predicting cardiovascular risk in this disease.


2017 ◽  
Vol 14 (1) ◽  
pp. 9
Author(s):  
Camilo  Palencia-Tejedor ◽  
Ruth  Azuaje-González ◽  
Óscar  Barrios-Benedeti ◽  
José  Ayala-Hernández ◽  
Carlos  Oberto-Machado ◽  
...  

                                                                        RESUMOObjetivo:  analisar  a  relação  existente  entre  os  parâmetros  de  avaliação  da  monitorização  ambulatorial de pressão arterial (pressão arterial, variabilidade, pressão de pulso, carga e padrão)  e o índice ambulatorial de rigidez arterial, de um hospital de quarto nível na cidade de Caracas,  Venezuela. Materiais e Métodos: realizou-se um estudo observacional retrospectivo, com uma  amostra significativa de 179 pacientes registrados na base dados de monitorização ambulatorial de  pressão arterial, na consulta cardiometabólica de um hospital, no período compreendido entre junho  a dezembro de 2014. Resultados: analisaram-se as monitorizações ambulatoriais de pressão arterial  de 179 pacientes em 24 horas, com idade média de 55 ± 16 anos, dos quais o 36,3 % era de sexo  masculino e o 87,0 % feminino, com um índice ambulatorial de rigidez arterial médio de 0,43 ± 0,17 e se utilizou a correlação de Pearson, com a pressão de pulso r = 0,50 p <0,001, com a idade r =  0,42 p <0,001, a pressão arterial sistólica r = 0,24 p = 0,001, a carga r = 0,20 p = 0,007. Conclusão: encontrou-se correlação positiva entre o índice ambulatorial de rigidez arterial e os parâmetros  de avaliação do índice ambulatorial de rigidez arterial, evidenciando que a rigidez ambulatorial  arterial é uma medida fácil de obter, que tem boa relação com fatores de risco conhecidos e pode ser  contemplada como parâmetro de controle e seguimento cardiovascular.PALAVRAS-CHAVE: monitorização ambulatorial, pressão arterial, rigidez arterial.Relación entre parámetros del monitoreo ambulatorio de presión arterial y el índice de rigidez arterial ambulatorio                                                                        RESUMENObjetivo: analizar la relación existente entre los parámetros de evaluación del monitoreo ambulatorio  de presión arterial (presión arterial, variabilidad, presión de pulso, carga y patrón) y el índice de rigidez  arterial ambulatorio, de un hospital de cuarto nivel en la ciudad de Caracas, Venezuela. Materiales y Métodos: se realizó un estudio observacional retrospectivo, con una muestra significativa de 179  pacientes registrados en la base datos del monitoreo ambulatorio de presión arterial, en la consulta  cardio-metabólica de un hospital, en el periodo comprendido entre junio a diciembre de 2014.  Resultados: se analizaron los monitoreos ambulatorios de presión arterial de 179 pacientes en 24  horas, con edad promedio 55  ± 16 años, de los cuales  el 36,3 % era de sexo masculino y el 87,0  % femenino, con un índice de rigidez arterial ambulatorio promedio de 0,43 ± 0,17 y se utilizó la  correlación de Pearson, con la presión de pulso r = 0,50 p <0,001, con la edad r = 0,42 p <0,001,  la presión arterial sistólica r = 0,24 p = 0,001, la carga r = 0,20 p = 0,007. Conclusión: se encontró  correlación positiva entre el índice de rigidez arterial ambulatorio y los parámetros de evaluación del  índice de rigidez arterial ambulatorio, evidenciando que la rigidez arterial ambulatoria es una medida  fácil de obtener, que tiene buena relación con factores de riesgo conocidos y puede ser contemplada  como parámetro de control y seguimiento cardiovascular.    PALABRAS CLAVE: monitoreo ambulatorio, presión arterial, rigidez arterial. Relationship between parameters of ambulatory blood pressure monitoring and ambulatory arterial stiffness                                                                     ABSTRACTObjective: To analyze the existent relationship between the evaluation parameters of ambulatory  blood pressure monitoring (blood pressure, variability, pulse pressure, load and pattern) and the  ambulatory arterial stiffness index, from a level IV hospital in the city of Caracas, Venezuela. Materials and Methods: a retrospective observational study was performed, with a significant sample of 179  patients registered in the database of blood pressure monitoring, in the cardio metabolic consultation  unit of a hospital, in the period between June and December of 2014. Results: the blood pressure  monitoring of 179 patients were analyzed in 24 hours, with an average age of 55 ± 16 years , from  which 36.3% were male and 87,0% female, with an average of arterial stiffness index of 0,43 ±  0,17  and the Pearson’s correlations was used, with pulse pressure r = 0,50 p <0,001, with the age  r = 0,42  p <0,001, the systolic blood pressure  r = 0,24 p = 0,001, the load r = 0,20 p = 0,007. Conclusion: a positive correlation was found between the arterial stiffness index and the parameters of evaluation  of ambulatory arterial stiffness index, evidencing that the ambulatory arterial stiffness is an easy  measure to obtain, that it has a good relation with known risk factors, and can be contemplated as a  parameter of control and cardiovascular monitoring.KEYWORDS: monitoring  ambulatory, arterial pressure, vascular stiffness. 


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