TY - JOUR
T1 - Association of 24-h central hemodynamics and stiffness with cardiovascular events and all-cause mortality.
T2 - The VASOTENS Registry
AU - Omboni, Stefano
AU - Alfie, Jose
AU - Arystan, Ayana
AU - Avolio, Alberto
AU - Barin, Edward
AU - Bokusheva, Jamilya
AU - Bulanova, Natalia
AU - Butlin, Mark
AU - Cuffaro, Paula
AU - Derevyanchenko, Maria
AU - Grigoricheva, Elena
AU - Gurevich, Alexandra
AU - Konradi, Alexandra
AU - Muiesan, Maria Lorenza
AU - Paini, Anna
AU - Pereira, Telmo
AU - Statsenko, Mikhail E
AU - Tan, Isabella
AU - VASOTENS Registry Study Group
N1 - Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - Objectives: In hemodialysis patients, central hemodynamics, stiffness, and wave reflections assessed through ambulatory blood pressure monitoring (ABPM) showed superior prognostic value for cardiovascular (CV) events than peripheral blood pressures (BPs). No such evidence is available for lower-risk hypertensive patients.Methods: In 591 hypertensive patients (mean age 58 ± 14 years, 49% males), ambulatory brachial and central BP, pulse wave velocity (PWV), and augmentation index (AIx) were obtained with a validated upper arm cuff-based pulse wave analysis technology. Information on treatment for hypertension (73% of patients), dyslipidemia (27%), diabetes (8%), CV disease history (25%), was collected. Patients were censored for CV events or all-cause death over 4.2 years.Results: One hundred and four events (24 fatal) were recorded. Advanced age [hazard ratio and 95% confidence interval: 1.03 (1.01, 1.05), P = 0.0001], female sex [1.57 (1.05, 2.33), P = 0.027], CV disease [2.22 (1.50, 3.29), P = 0.0001], increased 24-h central pulse pressure (PP) [1.56 (1.05, 2.31), P = 0.027], PWV [1.59 (1.07, 2.36), P = 0.022], or AIx [1.59 (1.08, 2.36), P = 0.020] were significantly associated with a worse prognosis (univariate Cox regression analysis). The prognostic power of peripheral and central BPs was lower. However, PWV [1.02 (0.64, 1.63), P = 0.924], AIx [1.06 (0.66, 1.69), P = 0.823], and central PP [1.18 (0.76, 1.82), P = 0.471], were not significant predictors in multivariate analyses.Conclusions: In hypertensive patients, ambulatory central PP, PWV, and AIx are associated with an increased risk of CV morbidity and all-cause mortality. However, this association is not independent of other patient characteristics.
AB - Objectives: In hemodialysis patients, central hemodynamics, stiffness, and wave reflections assessed through ambulatory blood pressure monitoring (ABPM) showed superior prognostic value for cardiovascular (CV) events than peripheral blood pressures (BPs). No such evidence is available for lower-risk hypertensive patients.Methods: In 591 hypertensive patients (mean age 58 ± 14 years, 49% males), ambulatory brachial and central BP, pulse wave velocity (PWV), and augmentation index (AIx) were obtained with a validated upper arm cuff-based pulse wave analysis technology. Information on treatment for hypertension (73% of patients), dyslipidemia (27%), diabetes (8%), CV disease history (25%), was collected. Patients were censored for CV events or all-cause death over 4.2 years.Results: One hundred and four events (24 fatal) were recorded. Advanced age [hazard ratio and 95% confidence interval: 1.03 (1.01, 1.05), P = 0.0001], female sex [1.57 (1.05, 2.33), P = 0.027], CV disease [2.22 (1.50, 3.29), P = 0.0001], increased 24-h central pulse pressure (PP) [1.56 (1.05, 2.31), P = 0.027], PWV [1.59 (1.07, 2.36), P = 0.022], or AIx [1.59 (1.08, 2.36), P = 0.020] were significantly associated with a worse prognosis (univariate Cox regression analysis). The prognostic power of peripheral and central BPs was lower. However, PWV [1.02 (0.64, 1.63), P = 0.924], AIx [1.06 (0.66, 1.69), P = 0.823], and central PP [1.18 (0.76, 1.82), P = 0.471], were not significant predictors in multivariate analyses.Conclusions: In hypertensive patients, ambulatory central PP, PWV, and AIx are associated with an increased risk of CV morbidity and all-cause mortality. However, this association is not independent of other patient characteristics.
KW - ambulatory blood pressure
KW - arterial stiffness
KW - augmentation index
KW - blood pressure telemonitoring
KW - central arterial pressure
KW - hypertension
KW - pulse wave velocity
KW - survival
KW - vascular biomarkers
UR - http://www.scopus.com/inward/record.url?scp=85200336226&partnerID=8YFLogxK
U2 - 10.1097/HJH.0000000000003763
DO - 10.1097/HJH.0000000000003763
M3 - Article
C2 - 38747378
SN - 1473-5598
VL - 42
SP - 1590
EP - 1597
JO - Journal of Hypertension
JF - Journal of Hypertension
IS - 9
ER -