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Hypertension. 2006;48:397-403
Published online before print July 31, 2006, doi: 10.1161/01.HYP.0000236599.91051.1e
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(Hypertension. 2006;48:397.)
© 2006 American Heart Association, Inc.

Original Articles

Increased Ambulatory Arterial Stiffness Index Is Associated With Target Organ Damage in Primary Hypertension

Giovanna Leoncini; Elena Ratto; Francesca Viazzi; Valentina Vaccaro; Angelica Parodi; Valeria Falqui; Novella Conti; Cinzia Tomolillo; Giacomo Deferrari; Roberto Pontremoli

From the Department of Cardio-Nephrology, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.

Correspondence to Roberto Pontremoli, Department of Internal Medicine, University of Genoa, and Department of Cardio-Nephrology, Azienda Ospedaliera Universitaria San Martino, Viale Benedetto XV 6, 16132 Genoa, Italy. E-mail roberto.pontremoli{at}unige.it

Increased arterial stiffness has been shown to predict cardiovascular mortality in patients with primary hypertension. Asymptomatic organ damage is known to precede cardiovascular events. We investigated the relationship between a recently proposed index of stiffness derived from ambulatory blood pressure (BP) and target organ damage in 188 untreated patients with primary hypertension. Ambulatory arterial stiffness index was defined as 1 minus the regression slope of diastolic over systolic BP readings obtained from 24-hour recordings. Albuminuria was measured as the albumin:creatinine ratio, left ventricular mass index was assessed by echocardiography, and carotid abnormalities were evaluated by ultrasonography. The prevalence of microalbuminuria, left ventricular hypertrophy (LVH), and carotid abnormalities was 12%, 38%, and 19%, respectively. Ambulatory arterial stiffness index was positively related to age, triglycerides, office and 24-hour systolic BP, 24-hour pulse pressure, urinary albumin excretion, and carotid intima-media thickness. Patients with microalbuminuria, carotid abnormalities, or LVH showed higher ambulatory arterial stiffness index as compared with those without it. After adjusting for confounding factors, each SD increase in ambulatory arterial stiffness index entails an &2 times higher risk of microalbuminuria, carotid abnormalities, and LVH and doubles the risk of the occurrence of ≥1 sign of organ damage. Ambulatory arterial stiffness index is associated with organ damage in patients with primary hypertension. These data strengthen the role of this index as a marker of risk and help to explain the high cardiovascular mortality reported in patients with high ambulatory arterial stiffness index.


Key Words: blood pressure monitoring • albuminuria • hypertrophy • hypertension, essential • carotid arteries


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