Document Detail


Ambulatory arterial stiffness index as a predictor of cardiovascular mortality in the Dublin Outcome Study.
MedLine Citation:
PMID:  16432047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We hypothesized that the dynamic relation between diastolic and systolic blood pressure over 24 hours provides a measure of arterial stiffness and might, therefore, predict cardiovascular mortality over and above pulse pressure. At baseline, while not on antihypertensive medication, 11 291 patients (mean age, 54.6 years; 5965 women) underwent ambulatory blood pressure monitoring. Using all of the blood pressure readings, we plotted diastolic against systolic blood pressure from each individual and calculated the regression slope. The ambulatory arterial stiffness index (AASI) was defined as 1 minus this regression slope. Over a median follow-up of 5.3 years, 566 cardiovascular deaths occurred, including 151 from stroke and 358 from cardiac disorders. Before and after adjustment for other cardiovascular risk factors, AASI and pulse pressure significantly predicted total cardiovascular mortality. AASI was a stronger predictor than pulse pressure for stroke (mutually adjusted relative hazard ratios for 1 SD increase, 1.21 versus 1.04; P=0.02 versus 0.66) with the opposite trend for cardiac mortality (relative hazard ratios, 1.03 versus 1.21; P=0.63 versus 0.002). In subjects with normal daytime ambulatory blood pressure (<135/<85 mm Hg), AASI was more predictive than pulse pressure of cardiovascular mortality (1.26 versus 0.96; P=0.04 versus 0.70) and of stroke mortality (1.81 versus 1.12; P=0.007 versus 0.58), whereas neither independently predicted cardiac mortality (1.11 versus 0.89; P=0.47 versus 0.40). AASI is a novel measure of arterial stiffness, which can be readily determined from ambulatory blood pressure recordings and which independently predicts cardiovascular mortality, even in normotensive subjects.
Authors:
Eamon Dolan; Lutgarde Thijs; Yan Li; Neil Atkins; Patricia McCormack; Sean McClory; Eoin O'Brien; Jan A Staessen; Alice V Stanton
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-01-23
Journal Detail:
Title:  Hypertension     Volume:  47     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-17     Completed Date:  2006-03-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  365-70     Citation Subset:  IM    
Affiliation:
The ADAPT Centre, Beaumont Hospital, Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin, Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arteries / physiopathology*
Blood Pressure*
Blood Pressure Monitoring, Ambulatory*
Cardiovascular Diseases / etiology,  mortality*
Compliance
Diastole
Female
Follow-Up Studies
Humans
Hypertension / complications,  physiopathology*
Ireland / epidemiology
Male
Middle Aged
Models, Cardiovascular*
Predictive Value of Tests
Proportional Hazards Models
Stroke / etiology,  mortality
Systole
Comments/Corrections
Comment In:
Hypertension. 2006 Mar;47(3):327-8   [PMID:  16432043 ]
Hypertension. 2006 Mar;47(3):325-6   [PMID:  16432046 ]
Hypertension. 2006 Dec;48(6):e108; author reply e109   [PMID:  17043160 ]
Hypertension. 2007 Feb;49(2):e7; author reply e8-9   [PMID:  17190871 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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