Ambulatory Arterial Stiffness Index and circadian blood pressure variability

Bahrainwala, Jehan; Patel, Ami M.; Diaz, Keith M.; Veerabhadrappa, Praveen; Cohen, Debbie L.; Cucchiara, Andrew J.; Townsend, Raymond R.

doi:10.1016/j.jash.2015.07.001

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…Complex mechanisms including endothelial damage, increased oxidative stress, activation of inflammation, and fibroproliferation may also lead to functional and/or structural blood vessel wall abnormalities in Cushing patients, and the effect of cortisol on vascular wall through indirect mechanisms cannot be excluded. In this regard, AASI has been found in hypertensive patients to correlate with BP variability [42], and we previously found that this parameter was higher in Cushing's syndrome than in their normotensive/essential hypertensive counterparts [19]. Moreover, the presence of comorbidities mainly diabetes and dyslipidemia, or certain lifestyle habits, that is, habitual smoking, are strong confounding factors for the evaluation of a potential role of cortisol per se in altering arterial wall properties.…”

Section: Nor-ctr Hyp-ctrmentioning

confidence: 96%

Ambulatory Arterial Stiffness Indexes in Cushing’s Syndrome

et al. 2017

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Long-standing exposure to endogenous cortisol excess is associated with high cardiovascular risk. The aim of our study was to investigate arterial stiffness, which has been recognized as an independent predictor of adverse cardiovascular outcome, in a group of patients with Cushing's syndrome. Twenty-four patients with Cushing's syndrome (3 males, mean age 49±13 years; 20 pituitary-dependent Cushing's disease and 4 adrenal adenoma) underwent 24-h ambulatory blood pressure monitoring (ABPM) and evaluation of cardiovascular risk factors. The Ambulatory Arterial Stiffness Index (AASI) and symmetric AASI (sAASI) were derived from ABPM tracings. Cushing patients were divided into 8 normotensive (NOR-CUSH) and 16 hypertensive (HYP-CUSH) patients, and were compared with 8 normotensive (NOR-CTR) and 16 hypertensive (HYP-CTR) control subjects, matched for demographic characteristics, 24-h ABPM and cardiometabolic risk factors. The AASI and sAASI indexes were significantly higher in Cushing patients than in controls, either in the normotensive (p=0.048 for AASI and p=0.013 for sAASI) or in the hypertensive (p=0.004 for AASI and p=0.046 for sAASI) group. No difference in metabolic parameters was observed between NOR-CUSH and NOR-CTR or between HYP-CUSH and HYP-CTR groups. AASI and sAASI were both correlated with urinary cortisol in patients with endogenous hypercortisolism (Spearman's rho=0.40, p=0.05, and 0.61, p=0.003, respectively), while no correlation was found in controls. Both AASI and sAASI are increased in Cushing syndrome, independent of BP elevation, and may represent an additional cardiovascular risk factor in this disease. The role of excess cortisol in arterial stiffness has to be further clarified.

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Section: Nor-ctr Hyp-ctrmentioning

confidence: 96%

Ambulatory Arterial Stiffness Indexes in Cushing’s Syndrome

et al. 2017

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“…Enhanced aortic stiffening is well documented in patients with CKD 91 – 93 and is closely related to increased short-term or 24-hour BP. 94 – 96 The mechanism for increased arterial stiffness in CKD and ESRD is likely multifactorial. 97 – 100 Vascular remodeling with changes in arterial wall composition and elasticity and arterial calcification, a pathological process linked to abnormal mineral metabolism in CKD, are major factors implicated in arterial stiffening.…”

Section: Mechanisms Of Altered Bp Variability and Circadian Rhythm Inmentioning

confidence: 99%

Ambulatory Blood Pressure in Chronic Kidney Disease: Ready for Prime Time?

Velasquez

Beddhu

Nobakht

et al. 2016

Kidney International Reports

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Hypertension is common in patients with chronic kidney disease (CKD) and is the most important modifiable risk factor for CKD progression and adverse cardiovascular events in these patients. Diagnosis and successful management of hypertension are critically dependent on accurate blood pressure (BP) measurement. This is most relevant to CKD patients, in whom BP control is difficult to achieve and in whom early antihypertensive treatment is imperative to prevent kidney and cardiovascular complications. Accumulated data indicate that ambulatory blood pressure monitoring (ABPM) is better in detecting hypertension than office BP measurement. ABPM is also a superior prognostic marker compared with office BP and has successfully identified hypertensive CKD patients at increased risk. Additionally, ABPM provides information on circadian BP variation and short-term BP variability, which is associated with cardiovascular and renal outcomes. This paper reviews the evidence for the usefulness of ABPM in detection and management of hypertension in CKD patients and discusses our current understanding of the pathophysiology of altered circadian BP rhythm and variability in CKD and the role of abnormal BP patterns detected by ABPM in relation to outcomes in CKD. In addition, this Review examines the emerging role of antihypertensive chronotherapy to tailor BP management to the circadian BP pattern abnormality detected by 24-hour ABPM.

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“…Слід наголосити, що це твердження ґрунтується на дослідженні здорових добровольців молодого віку [37]. Між тим, отримані в цьому дослідженні результати щодо денного та нічного а-АІРА виявилися тотожними результатам інших подібних досліджень, але з залученням пацієнтів з АГ [38,39]. Також треба зазначити, що така відмінність між денним та нічним а-АІРА, ймовірно, пов'язана з впливом циркадного ритму АТ на цей показник.…”

Section: вступunclassified

Determinants of short-term blood pressure variability – the value of arterial stiffness

Kanishcheva,

Bilchenko

2023

The Journal of v. N. Karazin Kharkiv National University, Series "Medicine"

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Abstract. Increased blood pressure variability is a significant parameter that affects the prognosis in patients with arterial hypertension, and is an independent predictor of cardiovascular events and mortality. The arterial elasticity is an important factor in maintaining a constant average blood pressure for adequate blood supply to inner organs against the background of dynamic blood pressure fluctuations. A decrease in the elastic properties of the arteries, and therefore, an increase in the arterial stiffness can be one of the potential mechanisms for the blood pressure variability violation. Objective. The aim of the study was to evaluate the possible relationships between arterial stiffness indicators and blood pressure variability indices in patients with hypertension based on the results of ambulatory blood pressure monitoring. Patients and methods. The results of ambulatory blood pressure monitoring of 172 patients with hypertension were analyzed. Arterial stiffness was assessed using the ambulatory arterial stiffness index - symmetric and asymmetric. SD, SDw, CV, SV, ARV, and BPVR indices were calculated to assess blood pressure variability. Analysis of the obtained results was carried out using Microsoft Excel 2010 and the STATISTICA version 10.0 software. Differences between groups were assessed by the Mann-Whitney method, correlations among blood pressure variability indices and ambulatory arterial stiffness indices were evaluated using Spearman`s rank correlation analysis. Significance was set at p ˂ 0.05. The results. Awake asymmetric ambulatory arterial stiffness index was significantly higher than asleep one, no statistically significant difference between asleep and 24-hour asymmetric ambulatory arterial stiffness index was established. The asleep symmetric ambulatory arterial stiffness index did not significantly differ from the awake one and was significantly higher than the 24-hour one. In comparison with asymmetric, for symmetric ambulatory arterial stiffness index statistically significant relationships were established for a greater number of blood pressure variability indices. In all statistically significant cases, the direction of the established relationship with arterial stiffness was only direct for the systolic blood pressure variability indices. Variability of diastolic blood pressure had a clear inverse relationship with arterial stiffness. Conclusions. The presence of pathogenetic interrelationships between arterial stiffness and blood pressure variability have been proven in the present study. The obtained results allow to state that arterial elasticity is an important component of blood pressure variability.

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Ambulatory Arterial Stiffness Index and circadian blood pressure variability

Cited by 10 publications

References 22 publications

Ambulatory Arterial Stiffness Indexes in Cushing’s Syndrome

Ambulatory Arterial Stiffness Indexes in Cushing’s Syndrome

Ambulatory Blood Pressure in Chronic Kidney Disease: Ready for Prime Time?

Determinants of short-term blood pressure variability – the value of arterial stiffness

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