Arterial Stiffness and Plasma Creatinine in Untreated Hypertensive Patients

Gosse, Philippe; Safar, Michel E.

doi:10.1016/j.amjhyper.2005.04.008

Cited by 33 publications

(22 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, recent studies have suggested an association between impaired renal function and decreased arterial stiffness in essential hypertensive patients. [11][12][13]20,21 In the present study, AASI and 24-h PP were inversely correlated with eGFR-MDRD and eGFR-EPI, independent of other cardiovascular risk factors, such as MBP. However, after adjusting for all the potential confounders, including AASI, 24-h PP and other risk factors, AASI (P¼0.053), but not 24-h PP (P¼0.081), was independently related to eGFR-EPI.…”

Section: Discussionmentioning

confidence: 62%

“…9 Alteration of arterial stiffness, a subclinical sign of TOD in hypertension, has been reported to be correlated with renal function within the normal range 10 or in renal dysfunction. [11][12][13][14][15][16][17] As a surrogate index of arterial stiffness, PP is correlated with early signs of renal dysfunction. 18,19 Similar to PP, AASI is also associated with TOD 20 and renal abnormalities 21,22 in untreated patients with primary hypertension.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of renal function with the ambulatory arterial stiffness index and pulse pressure in hypertensive patients

Wang

et al. 2011

Hypertens Res

View full text Add to dashboard Cite

Arterial stiffness exemplified by the ambulatory arterial stiffness index (AASI) and pulse pressure (PP) predicts cardiovascular morbidity and mortality. The present cross-sectional study assessed the association of renal function with AASI and 24-h PP in hypertensive inpatients. Subjects included 948 hypertensive inpatients with drug treatment (mean age, 53.3 years; male, 67.1%). The AASI was defined as 1 minus the regression slope of diastolic over systolic blood pressure readings obtained from 24-h recordings. Renal function was evaluated by serum creatinine and urinary albumin excretion was expressed by the urinary albumin-to-urinary creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR) was calculated by the modification of diet in renal disease formula and chronic kidney disease-epidemiology collaboration formula. As AASI and 24-h PP increased, serum creatinine concentrations and ACR increased, and eGFR decreased. Multiple linear regression showed that AASI and 24-h PP were associated with eGFR-EPI (B¼À12.00, P¼0.001 vs. B¼À0.14, P¼0.002) and ACR (B¼0.56, P¼0.004 vs. B¼0.01, P¼0.017) independent of other cardiovascular risk factors. After additional adjustment for 24-h PP, the association of AASI with eGFR-EPI had borderline significance (P¼0.053), whereas the significant associations of 24-h PP with serum creatinine and ACR persisted (P¼0.009 and P¼0.006) after adjusting for confounding factors and AASI. Multiple logistic regression analysis showed that each s.d. increase in 24-h PP (that is, 13 mm Hg) was associated with a higher risk of suffering from microalbuminuria (MA) by 39% (P¼0.038) after additional adjustment for AASI. In conclusion, AASI is more closely associated with eGFR compared with 24-h PP in hypertensive inpatients. However, for MA 24-h PP is a better predictor.

show abstract

Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Association of renal function with the ambulatory arterial stiffness index and pulse pressure in hypertensive patients

Wang

et al. 2011

Hypertens Res

View full text Add to dashboard Cite

show abstract

“…However, given the relatively weak association between GFR and upper-limb PWV, small sample size may have precluded the demonstration of a significant association in that study. In 263 hypertensive subjects with normal or mildly reduced GFR, Gosse and Safar 12 found a positive relation between plasma creatinine and QKD interval. Although correlated with more direct measures of arterial stiffness, 27 the QKD interval depends on several other variables, including ventricular activation and body height, and represents a cumulative measure of aortic and upper-limb PWV velocity, so the effects of renal function on central and peripheral stiffness could not be distinguished in that article.…”

Section: Kidney Disease and Peripheral Muscular Artery Stiffnessmentioning

confidence: 99%

“…10 Among people with mild renal failure, arterial stiffness is directly related to GFR. 11 In hypertensive patients, Gosse and Safar 12 have observed that the time interval between the R wave on the ECG and the last Korotkoff sound heard over the brachial artery when measuring blood pressure ([BP] named the QKD interval) is directly related to estimated GFR. QKD interval is considered an approximate measure of arterial transit time and, therefore, an estimate of arterial compliance, and that study suggests a relation between arterial stiffness and reduced GFR even in uncomplicated patients with essential hypertension.…”

mentioning

confidence: 99%

Relation Between Renal Function Within the Normal Range and Central and Peripheral Arterial Stiffness in Hypertension

et al. 2006

View full text Add to dashboard Cite

Abstract-Chronic kidney disease is accompanied by increased large-artery stiffness, but the relation between glomerular filtration rate within the reference range and central or peripheral arterial stiffness has been understudied. Key Words: hypertension Ⅲ glomerular filtration rate Ⅲ pulse wave velocity Ⅲ arterial stiffness Ⅲ artery C ardiovascular disease is the leading cause of death in chronic kidney disease, 1 and the development of premature and accelerated atherosclerosis in these patients is accounted for only in part by traditional risk factors. 2 One possible mechanism for this association might be represented by increased arterial stiffness, which is both a predictor of cardiovascular disease 3-5 and a correlate of reduced glomerular filtration rate (GFR). 6 -8 In patients with end-stage renal disease, a number of structural alterations of the arterial system occur, including stiffening of the aorta 9 and of the radial artery, a muscular artery free of atherosclerosis. 10 Among people with mild renal failure, arterial stiffness is directly related to GFR. 11 In hypertensive patients, Gosse and Safar 12 have observed that the time interval between the R wave on the ECG and the last Korotkoff sound heard over the brachial artery when measuring blood pressure ([BP] named the QKD interval) is directly related to estimated GFR. QKD interval is considered an approximate measure of arterial transit time and, therefore, an estimate of arterial compliance, and that study suggests a relation between arterial stiffness and reduced GFR even in uncomplicated patients with essential hypertension.However, several questions remain unanswered in this regard. First, it is unknown whether kidney function is related to arterial stiffness within the reference range of estimated GFR. Second, it is currently not clear whether a reduced GFR is not only a correlate of arterial stiffness at the aortic level but also at the level of the peripheral arteries. QKD interval is a combination of transit time along the elastic ascending aorta and the predominantly muscular upper-limb arteries. Aorta and muscular upperlimb arteries are affected to a different extent by age and cardiovascular risk factors; unlike aortic PWV, upper-limb PWV is not affected by age significantly. 13 The present investigation tested the hypothesis that in subjects with uncomplicated essential hypertension, changes

show abstract

“…Aortic stiffening causes increased systolic blood pressure (BP; SBP) and widened pulse pressure (PP), both factors associated in longitudinal studies with increased rate of decline of renal function. 6,7 In addition, aortic stiffening results in loss of the dampening of ventricular ejection and could lead to increased transmission of these pressure changes to organ microvasculature. 8 The renal microcirculation may be particularly affected because the low resistance provided by the renal afferent arterioles means that the glomerular capillaries are exposed to potentially damaging pulsatile pressures, which may result in a permanent reduction in glomerular filtration rate (GFR).…”

mentioning

confidence: 99%

Aortic Stiffness Is Independently Associated With Rate of Renal Function Decline in Chronic Kidney Disease Stages 3 and 4

Ford

Tomlinson²,

Chapman³

et al. 2010

Hypertension

196

164

View full text Add to dashboard Cite

Abstract-Aortic stiffness and chronic kidney disease are closely linked by shared risk factors and associated increased cardiovascular mortality. At lower levels of renal function, aortic stiffness is independently associated with glomerular filtration rate. However, the longitudinal impact of aortic stiffness on renal function has not been reported previously. A cohort of 133 patients with chronic kidney disease stages 3 and 4 (estimated glomerular filtration rate: 15 to 59 mL/min per 1.73 m 2 ) underwent prospective measurement of arterial stiffness parameters and monitoring of renal function. Aortic pulse wave velocity measurement was performed in 120 patients. The mean age was 69Ϯ12 years (meanϮSD; 103 men, 30 women, and 23.3% diabetic). Mean systolic blood pressure was 155Ϯ21 mm Hg, and mean diastolic blood pressure was 83Ϯ11 mm Hg. The mean Modification of Diet in Renal Disease estimated glomerular filtration rate was 32Ϯ11 mL/min per 1.73 m 2 . Change in renal function was measured using reciprocal creatinine plots and the dichotomous combined end point of Ն25% decline in renal function or start of renal replacement therapy. After stepwise multivariate analysis, aortic pulse wave velocity was independently associated with gradient of reciprocal creatinine plot (rϭ0.46; Pϭ0.014). In multivariate analysis of the end point of Ն25% decline in renal function or start of renal replacement therapy, independent predictors were aortic pulse wave velocity (rϭ0.48; Pϭ0.002), systolic blood pressure (rϭ0.17; Pϭ0.039), and urine protein:creatinine ratio (rϭ0.20; Pϭ0.021). We, therefore, conclude that aortic stiffening is independently associated with rate of change in renal function in patients with chronic kidney disease stages 3 and 4. (Hypertension. 2010;55:1110-1115.) Key Words: aorta Ⅲ pulse pressure Ⅲ microvessels Ⅲ kidney Ⅲ creatinine Ⅲ pulse pressure Ⅲ renal insufficiency C hronic kidney disease (CKD) is a common condition, affecting 10% to 13% of the population of the United States, 1 associated with a dramatically increased cardiovascular (CV) mortality, which increases with severity of renal impairment. This excess CV risk is in part attributed to an increase of traditional risk factors among people with CKD 2 but may also relate to the complex metabolic and vascular changes of CKD, including arterial stiffening. Aortic stiffness increases progressively as renal function declines 3 and has been independently associated with CV mortality in patients with renal failure. 4,5 Although much research has investigated the role of aortic stiffening in the causation of CV disease in patients with CKD, less attention has been paid to its potential etiologic role in the causation and progression of renal impairment. Aortic stiffening causes increased systolic blood pressure (BP; SBP) and widened pulse pressure (PP), both factors associated in longitudinal studies with increased rate of decline of renal function. 6,7 In addition, aortic stiffening results in loss of the dampening of ventricular ejection and could lead ...

show abstract

Arterial Stiffness and Plasma Creatinine in Untreated Hypertensive Patients

Cited by 33 publications

References 24 publications

Association of renal function with the ambulatory arterial stiffness index and pulse pressure in hypertensive patients

Association of renal function with the ambulatory arterial stiffness index and pulse pressure in hypertensive patients

Relation Between Renal Function Within the Normal Range and Central and Peripheral Arterial Stiffness in Hypertension

Aortic Stiffness Is Independently Associated With Rate of Renal Function Decline in Chronic Kidney Disease Stages 3 and 4

Contact Info

Product

Resources

About