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Objective:To assess the extent of hypertensive renal vascular damage by analyzing the correlation of the renal artery resistive index(RI)with the ambulatory arterial stiffness index(AASI)and pulse pressure.Methods:A retrospective case-control study was conducted enrolling 1 226 hypertension patients from the General Department of Beijing Chaoyang Hospital Affiliated to Capital Medical University between May 2018 and May 2023, and the hemodynamics of the renal artery were examined, with 187 patients showing abnormal blood flow, of whom, 78 were in the group with renal artery stenosis and 109 were in the group without renal artery stenosis, and 1, 039 had normal renal arterial blood flow(the control group). AASI and pulse pressure values were compared between hypertension patients with different degrees of increased resistance to renal blood flow; Spearman's rank correlation analysis was conducted to assess the correlation of AASI and pulse pressure with the degree of renal injury in elderly hypertension patients; The receiver operating characteristic(ROC)curves were plotted for hypertension patients with renal hemodynamic abnormalities based on the existence of renal artery stenosis and the results of RI, AASI and pulse pressure.Results:Patients in the renal artery stenosis, no renal artery stenosis, and control groups had statistically significant differences in RI[(0.83±0.05), (0.78±0.02), (0.71±0.03), F=410.44, P<0.01], AASI[(0.61±0.05), (0.58±0.06), (0.37±0.05), F=734.77, P<0.01], and pulse pressure[(1.71±0.15), (1.44±0.22), (0.88±0.25), F=968.99, P<0.01]; Compared with the group with no renal artery stenosis and the control group, the renal artery stenosis group also showed statistically significant differences in values of the three parameters( F=66.34, 9.87 and 160.51, respectively, P<0.05 for all). Pearson correlation analysis showed that RI was positively correlated with AASI and pulse pressure( r=0.730 and 0.762, respectively, P<0.01 for both). The cut-off value was 0.77 for RI, 0.52 for AASI and 1.31 for pulse pressure for renal artery stenosis in elderly hypertension patients, and the areas under the curve were 0.897, 0.830 and 0.951, respectively( P<0.05 for all); The sensitivities were 87%, 95% and 98% and the specificities were 68%, 67% and 71%, respectively. Conclusions:RI, AASI, and pulse pressure can effectively predict renal artery damage in middle-aged and elderly hypertension patients.
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Objective To explore the correlation between homocysteine (Hcy), uric acid, ambulatory arterial stiffness index (AASI) and left ventricular hypertrophy (LVH) in elderly H-type hypertensive patients. Methods Two hundred and forty-one patients or outpatients with essential hypertension between September 2016 and June 2018 from the Department of Cardiology and Geriatrics of the First Affiliated Hospital of Jinzhou Medical University were selected, and they were 60 to 79 years old. In the patients, 191 cases had H-type hypertension (H-type hypertension group), and 50 cases had non-H-type hypertension patients (non-H-type hypertension group). In the H-type hypertension patients, LVH was in 78 cases, and non-LVH in 113 cases. The general clinical data were gathered, and the Hcy and uric acid were detected. The 24 h ambulatory blood pressure monitoring was performed in all patients, and the AASI was calculated. Results There were no statistical differences in the hypertension duration, uric acid, AASI and left ventricular mass index (LVMI) between H-type hypertension group and non-H-type hypertension group (P＞0.05). In elderly H-type hypertension patients, the hypertension duration in LVH patients was significantly longer than that in non-LVH patients: (10.26 ± 3.95) years vs. (9.13 ± 3.05) years, the uric acid, AASI and Hcy were significantly higher than those in non-LVH patients: (433.7 ± 65.7) μmol/L vs. (400.6 ± 67.5) μmol/L, 0.54 ± 0.11 vs. 0.49 ± 0.12 and (16.84 ± 4.70) μmol/L vs. (14.12 ± 2.26) μmol/L, and there were statistical differences (P＜0.05 or ＜0.01). Pearson correlation analysis result showed that the Hcy, uric acid and AASI had positive correlation with LVMI in elderly H-type hypertension patients (r = 0.56, 0.53 and 0.45; P＜0.01). Binary Logistic regression analysis result showed that Hcy was the independent risk factor of LVH in elderly H-type hypertension patients ( OR = 1.225, 95% CI 1.106 to 1.357, P = 0.000), but uric acid and AASI were not associated with LVH in elderly H-type hypertension patients (P＞0.05). Conclusions Hcy, uric acid and AASI are associated with LVH in elderly H-type hypertension patients, and Hcy is an independent risk factor of LVH, but uric acid and AASI are not independent risk factors of LVH. Hcy can be used as a predictor of LVH. Hcy screening and intervention should thus be strengthened.
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Objective To evaluate the AASI in the prognosis of patients with coronary heart disease by investigating the correlation between ambulatory arterial stiffness index and degree of coronary artery stenosis and risk score.Methods A total of 187 patients admitted to our hospital with diagnosis of coronary heart disease from Januaty 2015 to June 2016 were grouped by AASI.We compared the data in different groups about common character,coronary lesion count and investigate the correlation between ambulatory arterial stiffness index and Gensini scores and GRACE score.Results The general clinical data:there were no significant differences in male patients,the proportion of smoking,blood lipids,urea nitrogen (BUN),creatinine (Cr),body mass index (BMI) between the two groups.Significant differences were observed in older patients and those with hypertension and diabetes.The number of disease dvessels,three vascular lesions in the increased AASI group was more than normal AASI group.AASI was correlated with total Gensini scores positively.AASI was correlated with GRACE score positively.Conclusion AASI not only helps estimate the degree of coronary artery stenosis lesions,but also can be used to predict the prognosis of coronary heart disease.
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Objective To evaluate the AASI in the prognosis of patients with coronary heart disease by investigating the correlation between ambulatory arterial stiffness index and degree of coronary artery stenosis and risk score.Methods A total of 187 patients admitted to our hospital with diagnosis of coronary heart disease from Januaty 2015 to June 2016 were grouped by AASI.We compared the data in different groups about common character,coronary lesion count and investigate the correlation between ambulatory arterial stiffness index and Gensini scores and GRACE score.Results The general clinical data:there were no significant differences in male patients,the proportion of smoking,blood lipids,urea nitrogen (BUN),creatinine (Cr),body mass index (BMI) between the two groups.Significant differences were observed in older patients and those with hypertension and diabetes.The number of disease dvessels,three vascular lesions in the increased AASI group was more than normal AASI group.AASI was correlated with total Gensini scores positively.AASI was correlated with GRACE score positively.Conclusion AASI not only helps estimate the degree of coronary artery stenosis lesions,but also can be used to predict the prognosis of coronary heart disease.
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Analizar los cambios del Índice de rigidez arterial ambulatorio y el Péptido Natriurético cerebral tipo B, ( IRAA y BNP) en 52 pacientes hipertensos que asistieron a la consulta Cardio-metabólica del Hospital Militar Dr. Carlos Arvelo, Caracas, Venezuela, entre enero y junio del 2015, antes y después del tratamiento antihipertensivo. Métodos: se realizó un ensayo clínico pareado, abierto, aleatorizado, donde los pacientes hipertensos de novo que cumplieron con los criterios de inclusión fueron asignados de forma aleatoria al grupo de trabajo. Se realizó seguimiento por tres meses posterior al inicio del tratamiento antihipertensivo. Se comparó la presión arterial media según el MAPA, IRAA y BNP en el primer y tercer mes en el grupo para evaluar éxito en alcanzar el control, así como también, se analizó la frecuencia de complicaciones cardiovasculares y muerte durante el estudio. Resultados: se encontró diferencia significativa entre los valores de AASI y BNP antes y después de 3 meses de tratamiento antihipertensivo (p= < 0,01) independientemente del tratamiento antihipertensivo utilizado en el grupo de estudio. Conclusión: El AASI y BNP mostraron ser modificables con el tratamiento antihipertensivo, y que ésta modificación se relaciona positivamente con los cambios de algunos de los parámetros del MAPA, como la Carga, la Presión de Pulso y la Presión Arterial Sistólica(AU)
to analyze the changes of AASI and BNP in hypertensive patients attending the Cardiometabolic consultation of Hospital Dr. Carlos Arvelo Military (Caracas, Venezuela) between January and June 2015, before and after antihypertensive treatment. Methods: this is a paired trial, open, clinical, randomized trial, where hypertensive patients recently diagnosed were randomly assigned to the study group. Monitoring was done three months after initiation of antihypertensive treatment. The mean blood pressure was compared according to ABPM, AASI and BNP from the first to the third month in the group to evaluate success in achieving control, and the frequency of cardiovascular complications and death during the study were also analyzed. Results: A significant difference was found between the values of AASI and BNP before and after 3 months of antihypertensive treatment ( p = <0,01) regardless of which antihypertensive treatment was used in the study group. Conclusion: The AASI and BNP were modified with antihypertensive treatment, and this change was positively related to changes in some parameters of the ABP Monitoring, such as Load, Pulse Pressure and Systolic. Blood Pressure(AU)
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Humans , Male , Female , Middle Aged , Aged , Vascular Stiffness/physiology , Hypertension/physiopathology , Antihypertensive Agents/administration & dosage , Cardiovascular Diseases , Internal MedicineABSTRACT
Objective To study the relationship between ambulatory arterial stiffness index and extent of coronary atherosclerosis.Methods All subjects were underwent coronary CT angiography.Ambulatory arterial stiffness index(AASI) was measured before coronary CT angiography.AASI value between different periods in each group were calculated and compared.Results AASI between different periods in the normal control group and coronary heart disease group existed statistical difference (P ＜ 0.05).The extent of coronary sclerosis and AASI between different periods in different coronary artery lesions groups were statistically different(P ＜0.05),AASI was proportional to the degree of coronary sclerosis,24 h AASI,DAASI,NAA SI were related to extent of coronary atherosclerosis lesions,the correlation coefficient between NAASI and extent of coronary atherosclerosis was the largest.Conclusion AASI night is related to coronary atherosclerosis most closely,namely the higher the value of the nighttime AASI,the greater the degree of coronary atherosclerosis.
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Objective To observe the changes of ambulatory arterial stiffness index (AASI) and target organ damage (TODs) after antihypertensive treatment in hypertensive patients .Methods A total of 300 cases of newly diagnosed hypertension were screened out and after strictly controlling blood pressure ,completed the ambulatory blood pressure and target organ damage inspection by 1‐year follow‐up .The dynamic changes of AASI and target organ damage were observed .Results After 1‐year anti‐hypertensive therapy ,AASI showed the gradually descending trend ,compared with before treatment ,began to decline at 6 months , decreased significantly after 1 year ;AASI showed the independent positive correlation with the intima‐media thickness(IMT) of ca‐rotid artery ,urine microalbumin(UMA) ,renal vascular resistance index(RRI) and left ventricular mass index(LVMI) ,and inde‐pendent negative correlation with endogenous creatinine clearance rate(Ccr) before and after treatment ;the multiple linear regres‐sion analysis showed that IMT ,UMA ,RRI ,Ccr and LVMI had significant correlation with AASI .After 1 year of therapy ,IMT , UMA ,RRI ,Ccr ,LVMI had shown some improvement(P<0 .05) .Conclusion AASI can be used as an indicator for evaluating arte‐riosclerosis and predicting the target organ damage in hypertension .
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Objective To investigate the relationship between correlative factors of ambulatory arterial stiffness in-dex (AASI) and target organ damage (TOD) in patients with primary hypertensive. Methods A total of 330 hypertensive pa-tients were included in the study and divided into two groups according to the value of AASI:low AASI group (n=167) and high AASI group (n=163). The value of AASI was obtained from 24-hour ambulatory blood pressure monitor (ABPM). The clinical data were collected including general information, the data of ABPM, results of coronary angiography, left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR) and ankle brachial index (ABI) in two groups. Results There were significantly higher values of age (years:64.91 ± 9.70 vs 59.12 ± 10.00), the proportion of diabetes (33.8% vs 14.8%), the proportion of non-dipper patterns of hypertension (65.6%vs 43.7%), 24-hour pulse pressure (PP, mmHg:65.27± 11.31 vs 56.06±10.51), 24-hour diastolic blood pressure standard deviation(DBPSD, mmHg:9.64±2.47 vs 8.31±2.31), the number of coronary artery lesions (1.78±1.10 vs 1.27±1.07), LVMI (g/m2:125.74±29.65 vs 107.69±23.23) and the proportion of peripheral vascular disease (27.3%vs 16.4%) in high AASI group than those in low AASI group (P<0.01). The level of eGFR was significantly lower in high AASI group than that in low AASI group [mL/(min · 1.73 m2):85.31 ± 20.31 vs 99.67 ± 17.76]. There were positive correlation between AASI and coronary lesions (r=0.235), LVMI(r=0.168) and peripheral vascu-lar disease (r=0.167). And there was a negative correlation between AASI and eGFR (r=-0.187). The multiple linear regres-sion analysis showed that age, diabetes, PP, DBPSD and non-dipper patterns of hypertension were the predictors of AASI. Conclusion AASI correlated with age, diabetes, PP, blood pressure variability and non-dipper patterns of hypertension. The higher level of AASI may relate to the development of TOD in patients with primary hypertensive.
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Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients. Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording. Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.
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Objective To investigate the correlations between ambulatory arterial stiffness index and intracranial/extracranial arterial stenosis.Methods One hundred and twenty-eight cases of ischemic cerebrovascular disease were collected in our hospital from January 2010 to March 2012.Joint diagnosis of cranial computer tomography(TCD) and magnetic resonance angiography (MRA) and,or CT angiography (CTA) were used to detect the degree and number of intracranial arteries,and in accordance with the lesions level,patients were divided into stenosis group,the mild stenosis group,the moderate stenosis group and severe stenosis group.24 h ambulatory blood pressure was monitored and ambulatory arterial stiffness index (AASI) was calculated and statistically analyzed.Results (1) Age,sex,hypertension proportion of diabetes,body mass index(BMI) of different Intracranial arterial stenosis in four groups did not have significant differences (P ＞0.05),but in AASI the without stenosis group is 0.48 ± 0.15 ; the mild stenosis group 0.62 ± 0.16,the moderate stenosis group 0.61 ± 0.17,severe stenosis group 0.64 ± 0.15,and there was significant difference (F =3.955,P =0.001).(2) Age,sex,hypertension proportion of diabetes,BMI of different extracranial arterial stenosis in four groups did not have significant differences (P ＞ 0.05),but in AASI the without stenosis group was 0.48 ± 0.01 ; the mild stenosis group 0.57 ± 0.11,the moderate stenosis 0.59 ± 0.12,and severe group 0.60 ±0.15,and there was significant difference (F =3.643,P =0.002).In comparison between any two group:light,moderate and severe stenosis AASI were significantly higher than those without stenosis,and there was significant difference (P ＜ 0.05).And there was significant different in AASI among different intracranial and extracranial arterial lesions (F =7.395,P ＜ 0.001).Compared to 0 branch pathological changes,1 branch,2 branch,3 branch and above,there was was significant difference(P ＜ 0.05).Conclusion Based on a 24-hour ambulatory blood pressure monitoring indicators,AASI was mainly reflecting the impact of atherosclerosis on blood pressure,associated with intracranial and extracranial artery stenosis.AASI would play a major role in clinical diagnosis and treatment of ischemic cerebrovascular and forecast.
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Objective To investigate the relationship between Ambulatory Arterial Stiffness Index (AASI)and kidney damage or carotid endarterectomy damage in hypertension patients.Methods One hundred and forty-nine patients with hypertension but without diabetes or other arteriosclerosis diseases were enrolled.Forty-eight healthy volunteers during the same period were enrolled as control group.All participants'24 h-ambulatory blood pressure monitoring(ABPM),urinary albumin/creatinine ratio(ACR)and IMT were recorded and AASI was calculated.Then the correlation between AASI and ACR or IMT were calculated.Results There were significant differences in the urinary albumin/creatinine ratio(46.34 vs.33.52)(P ＜ 0.05),microalbuminuria incidence(41％ vs.21％),Carotid intima-media thickness([0.90 ±0.21]mm vs.[0.83 ±0.20]mm),abnormal incidence(72％ vs.60％)and AAS1(0.50 ± 0.16 vs.0.42 ± 0.17)(P ＜ 0.01)between the subjects with hypertension and those without.The AASI were positively correlated with ACR and IMT in hypertension patients.Compared with healthy subjects,the AASI were significantly increased in the patients with abnormal CR and IMT(P ＜0.05 、P ＜0.01).Conclusion The AASI were correlated with kidney damage and carotid endarterectomy damage in hypertension patients.
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@#Objective To investigate the relationship between ambulatory arterial stiffness index (AASI) derived from blood pressure monitoring and early signs of renal damage in patients with primary hypertension． Methods 74 primary hypertensive outpatients were divided into two groups according to their AASI values: normal AASI group (AASI≤0.51, n=40) and high AASI group (AASI>0.51, n=32). The urinary micro-albumin, glomerular filtration rates (GFR) were measured and compared. The relationship between AASI and micro-albumin, GFR were tested with Pearson correlation and multiple Logistic regression. Results Compared with those in the normal AASI group, the patients in high AASI group showed a higher level of urinary microalbumin (P<0.05) and a reduction in GFR (P<0.01). AASI was positively correlated with urinary microalbumin （r=0.32, P<0.001）, and negatively correlated with GFR （r=0.44, P<0.001）. After adjusting the potentially confounding variables, the odd ratio (OR) of AASI to renal damage was 2.18 （P=0.008，95%CI：1.76～4.34）. Conclusion The increase of AASI is associated with early signs of renal damage in patients with primary hypertension.
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Mective To study the correlation of ambulatory arterial stiffness index(AASI)and pule wave velocity(PWV),explore the evaluation of AASI on arterial stiffness and analyze the influential factors of AASI.Method One hundred patients were selected,brachial-ankle pulse wave velocity (baPWV)of all patients wag measured,simultaneously 24-hour ambulatory blood pressure Wag examined, calculated AASI.AASI and baPWV were analyzed with correlation and regression analysis.Results AASI Wagpositively and signifieandy correlatedwithPWV(r＝0.516,P＜0.01)and age(r＝0.417,P＜0.01). AASIWag negatively correlatedwithbody height(r＝-0.223,P＜0.05).Themultiplefactor stepwise regres-sion analysis showed that the regression of AASl with PWV were great significant.Conclusions AASI is positively and significantly correlated with PWV.It is a novel meagure ofartdrial stiffness.