Assessment of Arterial Stiffness Index in Hypertensive Patients in Relation to Their Treatment Status Attending a Tertiary Care Center in South India

Shourya Kola¹, Melvin George², Suresh Kumar Srinivasamurthy³, Sandhiya Selvarajan^3*, Kadhiravan Tamilarasu⁴, Rathinam Palamalai Swaminathan⁴, Adithan Chandrasekaran³

¹Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.
²Cardiac Clinical Trials and Research, Department of Cardiology, SRM Medical College, Hospital and Research Centre, Chennai, India.
³Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.
⁴Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India.

DOI: 10.4236/pp.2014.54050                

Abstract

Objectives: To assess the arterial stiffness index (ASI) and pulse wave velocity (PWV) in patients with hypertension and to compare with age matched healthy controls; to assess and compare the ASI and PWV in relation to the treatment status. Methods: The study was observational-cross sectional. Group one included chronic hypertensive patients on regular treatment for more than 2 months; group two included newly diagnosed hypertensive patients and group three had age matched healthy controls with normal blood pressure. The hypertensives subjects with other comormid conditions such as renal disease, diabetes were excluded from the study. The study was approved by the Institute Ethics Committee. The subjects were interviewed and explained the purpose of the study. All subjects gave written informed consent. The noninvasive periscope device was used to measure PWV, ASI and pulse pressure. Results: PWV, ASI and pulse pressure were statistically higher in hypertensive patients when compared to controls. Further, carotid-femoral PWV was correlated with mean arterial pressure in hypertensive subjects and was found to be statistically significant. Conclusion: PWV, ASI and pulse pressure are significantly higher in chronic and newly diagnosed non-diabetic hypertensives as compared to controls irrespective of their treatment status.

Keywords

Pulse Wave Velocity; Arterial Stiffness Index; Hypertension; Antihypertensives

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	WHO (2012) World Health Report 2002 Press Kit. http://www.who.int/whr/2002/media_centre/en/index.html
[2]	WHO (2012) World Health Statistics 2008. http://www.who.int/gho/publications/world_health_statistics/EN_WHS08_Full.pdf
[3]	Kearney, P.M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P.K. and He, J. (2005) Global Burden of Hypertension: Analysis of Worldwide Data. Lancet, 365, 217-223. http://dx.doi.org/10.1016/S0140-6736(05)17741-1
[4]	Howell, S.J., Sear, J.W. and Foëx, P. (2004) Hypertension, Hypertensive Heart Disease and Perioperative Cardiac Risk. British Journal of Anaesthesia, 92, 570-583. http://dx.doi.org/10.1093/bja/aeh091
[5]	Laurent, S., Boutouyrie, P., Asmar, R., Gautier, I., Laloux, B., Guize, L., et al. (2001) Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patient. Hypertension, 37, 1236-1241. http://dx.doi.org/10.1161/01.HYP.37.5.1236
[6]	Laurent, S., Cockcroft, J., Van Bortel, L., Boutouyrie, P., Giannattasio, C., Hayoz, D., et al. (2006) Expert Consensus Document on Arterial Stiffness: Methodological Issues and Clinical Applications. European Network for Non-Invasive Investigation of Large Arteries. European Heart Journal, 27, 2588-2605. http://dx.doi.org/10.1093/eurheartj/ehl254
[7]	Palatini, P., Casiglia, E., Gasowski, J., Gluszek, J., Jankowski, P., Narkiewicz, K., et al. (2011) Arterial Stiffness, Central Hemodynamics, and Cardiovascular Risk in Hypertension. Vascular Health and Risk Management, 7, 725-739. http://dx.doi.org/10.2147/VHRM.S25270
[8]	Dolan, E., Thijs, L., Li, Y., Atkins, N., McCormack, P., McClory, S., et al. (2006) Ambulatory Arterial Stiffness Index as a Predictor of Cardiovascular Mortality in the Outcome Study. Hypertension, 47, 365-370. http://dx.doi.org/10.1161/01.HYP.0000200699.74641.c5
[9]	Blacher, J., Asmar, R., Djane, S., London, G.M. and Safar, M.E. (1999) Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive Patients. Hypertension, 33, 1111-1117. http://dx.doi.org/10.1161/01.HYP.33.5.1111
[10]	Willum-Hansen, T., Staessen, J.A., Torp-Pedersen, C., Rasmussen, S., Thijs, L., Ibsen, H., et al. (2006) Prognostic Value of Aortic Pulse Wave Velocity as Index of Arterial Stiffness in the General Population. Circulation, 113, 664-670. http://dx.doi.org/10.1161/CIRCULATIONAHA.105.579342
[11]	Benetos, M.S., Rudnichi, A., Smulyan, H., Richard, J.L., Ducimetieère, P., et al. (1997) Pulse Pressure. A Predictor of Long-Term Cardiovascular Mortality in a French Male Population. Hypertension, 30, 1410-1415. http://dx.doi.org/10.1161/01.HYP.30.6.1410
[12]	Naidu, M.U., Reddy, B.M., Yashmaina, S., Patnaik, A.N. and Rani, P.U. (2005) Validity and Reproducibility of Arterial Pulse Wave Velocity Measurement Using New Device with Oscillometric Technique: A Pilot Study. BioMedical Engineering OnLine, 4, 49. http://dx.doi.org/10.1186/1475-925X-4-49
[13]	Arcaro, G., Laurent, S., Jondeau, G., Hoeks, A.P. and Safar, M.E. (1991) Stiffness of the Common Carotid Artery in Treated Hypertensive Patients. Journal of Hypertension, 9, 947-954. http://dx.doi.org/10.1097/00004872-199110000-00008
[14]	Asmar, R. (2001) Effect of Antihypertensive Agents on Arterial Stiffness as Evaluated by Pulse Wave Velocity: Clinical Implications. American Journal of Cardiovascular Drugs, 1, 387-397. http://dx.doi.org/10.2165/00129784-200101050-00008
[15]	Benetos, B.W., Izzo, J., Mitchell, G., Resnick, L., Asmar, R., et al. (2002) Influence of Age, Risk Factors, and Cardiovascular and Renal Disease on Arterial Stiffness: Clinical Applications. American Journal of Hypertension, 15, 1101-1108. http://dx.doi.org/10.1016/S0895-7061(02)03029-7
[16]	Nordstrand, N., Gjevestad, E., Dinh, K.N., Hofsø, D., Røislien, J. and Saltvedt, E. (2011) The Relationship between Various Measures of Obesity and Arterial Stiffness in Morbidly Obese Patients. BMC Cardiovascular Disorders, 11, 7. http://dx.doi.org/10.1186/1471-2261-11-7
[17]	Vlachopoulos, C., Kosmopoulou, F., Panagiotakos, D., Ioakeimidis, N., Alexopoulos, N., Pitsavos, C., et al. (2004) Smoking and Caffeine Have a Synergistic Detrimental Effect on Aortic Stiffness and Wave Reflections. Journal of the American College of Cardiology, 44, 1911-1917. http://dx.doi.org/10.1016/j.jacc.2004.07.049
[18]	Duprez, D.A. (2010) Is Vascular Stiffness a Target for Therapy? Cardiovascular Drugs and Therapy, 24, 305-310. http://dx.doi.org/10.1007/s10557-010-6250-z