ASSESSMENT OF ARTERIAL STIFFNESS BY 24-HS AMBULATORY BLOOD PRESSURE MONITORING IN NOCTURNAL HYPERTENSIVE AND NORMOTENSIVE SUBJECTS.

S. PEREZ-LLORET; L. DRUCAROFF; D. CARDINALI; R. SANCHEZ; A. RAMIREZ

Milan, Italia

Congreso; Congreso de la Sociedad Europea de Hipertension; 2007

Background: Nocturnal hypertension, male gender, age and arterial stiffness are important risk factors for cardiovascular morbidity and mortality.Nocturnal hypertension, male gender, age and arterial stiffness are important risk factors for cardiovascular morbidity and mortality. Aims: To assess the arterial stiffness, evaluated by the Ambulatory Arterial Stiffness Index (AASI), in nocturnal hypertensive or normotensive men and women over 40 years of age.To assess the arterial stiffness, evaluated by the Ambulatory Arterial Stiffness Index (AASI), in nocturnal hypertensive or normotensive men and women over 40 years of age. Methods: 24-h ambulatory blood pressure monitoring was performed in 144 men and 137 women. Eighty-eight subjects were between 40 and 49 years old (53% men), 98 were between 50 and 59 years old (55% men) and 95 were over 60 years old (45% men). They were classified as nocturnal hypertensive if their average night-time blood pressure was > 120/70 mmHg. AASI, as a dynamic arterial stiffness index, is calculated as 1 minus the slope of diastolic (DBP) on systolic (SBP) blood pressure values from the 24-h recording period. Data were analyzed by analysis of covariance adjusted for 24-hour mean arterial pressure, height, heart rate and antihypertensive treatment.24-h ambulatory blood pressure monitoring was performed in 144 men and 137 women. Eighty-eight subjects were between 40 and 49 years old (53% men), 98 were between 50 and 59 years old (55% men) and 95 were over 60 years old (45% men). They were classified as nocturnal hypertensive if their average night-time blood pressure was > 120/70 mmHg. AASI, as a dynamic arterial stiffness index, is calculated as 1 minus the slope of diastolic (DBP) on systolic (SBP) blood pressure values from the 24-h recording period. Data were analyzed by analysis of covariance adjusted for 24-hour mean arterial pressure, height, heart rate and antihypertensive treatment. Results: Women (0.32±0.01) showed higher AASI as compared to men (0.27±0.01; p<.02), independently of age. Nocturnal hypertensive women showed higher AASI values than their respective nocturnal normotensive controls in the 50-59 years old (0.47±0.06 vs. 0.30±0.02, respectively, p<.05) and >60 years old groups only (0.45±0.03 vs. 0.33±0.03, respectively, p<.05). No differences were found in the 40-49 years old group (0.24±0.02 vs. 0.29±0.05, respectively, p<.1). Similarly, AASI in men increased with age (40-49 y: 0.22±0.02, 50-59 y: 0.27±0.03, >60 y: 0.38±0.02, p<.001). However, independently of age, the values were higher in nocturnal hypertensives (0.33±0.02) than in nocturnal normotensives (0.24±0.02, p<.01).Women (0.32±0.01) showed higher AASI as compared to men (0.27±0.01; p<.02), independently of age. Nocturnal hypertensive women showed higher AASI values than their respective nocturnal normotensive controls in the 50-59 years old (0.47±0.06 vs. 0.30±0.02, respectively, p<.05) and >60 years old groups only (0.45±0.03 vs. 0.33±0.03, respectively, p<.05). No differences were found in the 40-49 years old group (0.24±0.02 vs. 0.29±0.05, respectively, p<.1). Similarly, AASI in men increased with age (40-49 y: 0.22±0.02, 50-59 y: 0.27±0.03, >60 y: 0.38±0.02, p<.001). However, independently of age, the values were higher in nocturnal hypertensives (0.33±0.02) than in nocturnal normotensives (0.24±0.02, p<.01). Conclusions: Arterial stiffness instead of being higher in both groups of patients in an age dependent way, is higher among nocturnal hypertensive subjects, especially in women over 50 years old. This supports the idea that these subjects are under a higher risk of cardiovascular events. Thus, the identification of nocturnal hypertension and changes in AASI, by non-invasive techniques, could be useful tools for a better evaluation of cardiovascular risk and prevention.Arterial stiffness instead of being higher in both groups of patients in an age dependent way, is higher among nocturnal hypertensive subjects, especially in women over 50 years old. This supports the idea that these subjects are under a higher risk of cardiovascular events. Thus, the identification of nocturnal hypertension and changes in AASI, by non-invasive techniques, could be useful tools for a better evaluation of cardiovascular risk and prevention.