Association of office and 24-hour ambulatory measurement of aortic pulse wave velocity with target organ damage in hypertension

Introduction: The aim of this study was to assess the association of office arterial stiffness and 24 h arterial stiffness as measured by pulse wave velocity (PWV) with subclinical target organ damage (TOD) in a hypertensive cohort.

Methods: We evaluated associations of TOD with office carotid-femoral PWV (cf-PWV) by radial tonometry (SphygmoCor) and 24-h ambulatory PWV measurements by brachial oscillometry (Mobil-O-Graph 24-h PWA Monitor) in 636 hospital inpatients (age 54 ± 13 years, 465 males) with primary hypertension. Subclinical TOD was assessed as left ventricular hypertrophy (LVH) obtained by echocardiography quantified by LV mass index (LVMI), carotid intima-media thickness (CIMT) >0.9 mm and chronic kidney disease including urine albumin-creatinine ratio (ACR) >3.5 mg/mmol in females and >2.5 mg/mmol in males or estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m 2.

Results: After adjusting for confounding factors, both cf-PWV and 24-h PWV or night-PWV showed significant association with LVMI ( p < 0.05). Only day-PWV was associated with eGFR ( p = 0.037). When cf-PWV, 24-h PWV, day- and night-PWV including confounding factors were forced into the same logistic regression model, only cf-PWV (OR = 1.109 [1.001-1.228], p = 0.033) remained a significant determinant of increased LVH. Day-PWV (OR = 0.538 [0.415-0.696], p < 0.001) was significantly correlated with eGFR. For ACR, each 1 m/s increase in day-PWV was associated with risk of increased ACR (OR = 1.685 [1.178-2.410], p = 0.004). For CIMT >0.9 mm, neither ambulatory PWV nor cf-PWV was significant.

Conclusion: Compared with 24-h ambulatory PWV, cf-PWV has a better correlation with LVH, while ambulatory PWV has a greater correlation with the decline in renal function.