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(Hypertension. 2006;47:359.)
© 2006 American Heart Association, Inc.

Original Articles

Ambulatory Arterial Stiffness Index Derived From 24-Hour Ambulatory Blood Pressure Monitoring

Yan Li; Ji-Guang Wang; Eamon Dolan; Ping-Jin Gao; Hui-Feng Guo; Tim Nawrot; Alice V. Stanton; Ding-Liang Zhu; Eoin O’Brien; Jan A. Staessen

From the Centre for Epidemiological Studies and Clinical Trials (Y.L., J.G.W., P.J.G., H.F.G., D.L.Z.), Ruijin Hospital, Shanghai Institute of Hypertension, Shanghai Second Medical University, Shanghai, China; Study Coordinating Centre (T.N., J.A.S.), Hypertension and Cardiovascular Rehabilitation Unit, Department of Cardiovascular Disease, University of Leuven, Belgium; ADAPT Centre and Blood Pressure Unit, Beaumont Hospital, and the Department of Clinical Pharmacology (E.D., A.S., E.O.B.), Royal College of Surgeons in Ireland, Dublin, Ireland.

Reprint requests to Ding-Liang Zhu, Ruijin Hospital, Shanghai Institute of Hypertension, Ruijin Second Road 197, 20025 Shanghai, China. E-mail zhudingliang{at}sibs.ac.cn

We hypothesized that 1 minus the slope of diastolic on systolic pressure during 24-hour ambulatory monitoring (ambulatory arterial stiffness index [AASI]) might reflect arterial stiffness. We compared AASI with established measures of arterial stiffness and studied its distribution in Chinese and European populations. We used 90207 SpaceLabs monitors and the SphygmoCor device to measure AASI, central and peripheral pulse pressures, the central (CAIx) and peripheral (PAIx) systolic augmentation indexes, and aortic pulse wave velocity. In 166 volunteers, the correlation coefficient between AASI and pulse wave velocity was 0.51 (P<0.0001). In 348 randomly recruited Chinese subjects, AASI correlated (P<0.0001) with CAIx (r=0.48), PAIx (r=0.50), and central pulse pressure (r=0.50). AASI increased with age and mean arterial pressure but decreased with body height. Both before and after adjustment for arterial wave reflections by considering height and heart rate as covariates, AASI correlated more (P<0.0001) closely with CAIx and PAIx than 24-hour pulse pressure. Among normotensive subjects, the 95th percentile of AASI was 0.55 in Chinese and 0.57 in 1617 Europeans enrolled in the International Database on Ambulatory Blood Pressure Monitoring. The upper boundary of the 95% prediction interval of AASI in relation to age ranged from 0.53 at 20 years to 0.72 at 80 years. In conclusion, AASI is a new index of arterial stiffness that can be easily measured under ambulatory conditions. Pending additional validation in outcome studies, normal values of AASI are probably <0.50 and 0.70 in young and older subjects, respectively.

Key Words: blood pressure monitoring, ambulatory • arteries • blood pressure • epidemiology • population

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