Original Article | Published:

Treatment-induced changes in ambulatory arterial stiffness index: one-year prospective study and meta-analysis of evidence

Hypertension Research volume 38, pages 627631 (2015) | Download Citation

Abstract

The ambulatory arterial stiffness index (AASI) has been introduced as an index of arterial function, predicting cardiovascular events. However, treatment-induced changes in AASI are rather equivocal. This study aims to: (i) present the results of treatment-induced changes in AASI in untreated subjects with elevated blood pressure (BP), subjected to antihypertensive treatment for 1 year and (ii) perform a meta-analysis of studies reporting on treatment-induced change in AASI. A total of 104 subjects (mean age 51.4±10.3 years, 62% males, mean follow-up: 13.6±2.4 months) were analyzed. Despite significant reductions in 24-h ambulatory systolic/diastolic BP, pulse pressure and pulse wave velocity (mean change: −15.9±12/−10.4±7.6 mm Hg, −5.4±6.8 mm Hg, −0.7±1.9 m s−1, respectively, all P<0.05), there was no significant change (Follow up—Baseline) in AASI values (mean change: 0.01±0.17, P=not significant). The treatment-induced change in AASI was correlated with baseline AASI (r=−0.61), baseline 24-h pulse pressure (−0.26), treatment-induced change in 24-h pulse pressure (0.26) and in systolic/diastolic nocturnal dipping (−0.25/−0.40, respectively). Meta-analysis of eight trials (n=990) revealed a marginal decrease in AASI with antihypertensive treatment (pooled change: −0.018 (95% confidence interval (CI): −0.033,−0.003)). When the analysis was restricted to data with renin-angiotensin system blockers (n=755, 76% of total), the results did not significantly change (pooled change −0.028 (95% CI −0.048, −0.007)). In conclusion, although AASI is an independent predictor of cardiovascular events, its response to antihypertensive treatment is only marginal and clinically uncertain, which may render its use as a therapeutic target in clinical practice questionable.

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Author information

Author notes

    • Anastasios Kollias
    •  & Vayia Rarra

    These authors contributed equally to this work.

Affiliations

  1. Hypertension Center, STRIDE -7, Third University Department of Medicine, Sotiria Hospital, Athens, Greece

    • Anastasios Kollias
    • , Vayia Rarra
    • , Nikos Karpettas
    • , Leonidas Roussias
    •  & George S Stergiou
  2. Conway Institute, University College, Dublin, Ireland

    • Eoin O'Brien

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The authors declare no conflict of interest.

Corresponding author

Correspondence to George S Stergiou.

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DOI

https://doi.org/10.1038/hr.2015.44

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