Journal of the American Society of Hypertension
The “backstage” of augmentation index evaluated by pulse wave analysis
Section snippets
Aims
To evaluate arterial stiffness by pulse wave analysis (Augmentation Index, AIx) in a population with moderate-high cardiovascular risk.
Methods
N= 118. Type 1 diabetes and latent autoimmune diabetes in adults were excluded. Age: 59.2 (12.9) y.o. 71 males (60.2 %). Hypertensive 87 (73.7%). Hyperglycemia 81 (68.6 %). Type 2 diabetes 46 (39%). Smokers 31 (26.3%). Metabolic Syndrome (MS): ATP-III-2005. Pulse wave analysis by SphygmoCor (AtCor Medical). AIx adjusted to 75 bpm (AIx@75). TG, cholesterol, cHDL, cLDL and uric acid (mg/dl): HITACHI. High-sensitivity C-reactive protein (hsCRP, mg/L): nephelometric. Statistical: mean, standard
Results
As expected, a strong linear correlation /p< 0.001) between AIx@75 and age was found in both males (R2=0.395) and females (R2=0.33. Female sex was associated to a higher AIx@75 in the whole age range: R2=0.443, p< 0.001. After adjustment by sex and age, AIx@75 was significantly associated with smoking (β=3.93; p=0.030; R2=0.468), peripheral diastolic blood pressure (DBP) (β = 0.227; p=0.041. R2=0.465), central systolic blood pressure (SBP) (β=0.133; p=0.029. R2=0.468), central DBP (β= 0.252;
Discussion
The arterial stiffness seems to be a prognostic and independent biomarker of cardiovascular risk. Pulse wave analysis is a non-invasive tool to evaluate arterial stiffness. The increase of stiffness is the result of a series of structural and functional changes taking place in the vessel wall in relation to aging, but whose speed could be modified by genetic aspects, life-style and risk factors. The analysis of the pulse wave morphology estimates carotid pulse from radial artery, providing a
Conclusions
Aging was the main determinant factor of AIx@75. By gender, females showed higher values. After adjustment by sex and age, smoking status, central SBP and central and peripheral DBP significantly contribute to explain variability of AIx@75, but not chronic hyperglycemia, Metabolic Syndrome, hypertension, SBP, nor waist circumference. Now we better know the determinant factors of arterial stiffness.
Keywords
augmentation index; pulse wave analysis; stiffness arterial; cardiovascular risk