A blunted decrease in nocturnal blood pressure is independently associated with increased aortic stiffness in...

Area of Science:

• Cardiovascular Medicine
• Hypertension Research
• Vascular Biology

Background:

• Arterial stiffness is a potential cause of resistant hypertension.
• Understanding factors associated with aortic stiffness in resistant hypertension is crucial for risk stratification and management.

Purpose of the Study:

• To investigate variables, especially from ambulatory blood pressure monitoring (ABPM), associated with increased aortic stiffness in resistant hypertensive patients.
• To identify independent correlates of elevated aortic pulse wave velocity (PWV) in this population.

Main Methods:

• A cross-sectional study of 600 resistant hypertensive patients without peripheral arterial disease.
• Aortic stiffness assessed by aortic pulse wave velocity (PWV; increased if >12 m/s).
• Statistical analyses included multiple linear and logistic regressions using ABPM data.

Main Results:

• 28% of patients had increased aortic PWV (>12 m/s).
• Increased PWV correlated with older age, higher cardiovascular risk factors, elevated daytime/nighttime systolic BP and pulse pressures, and a non-dipping BP pattern.
• Independent correlates of aortic PWV included age, 24-h pulse pressure, low HDL-cholesterol, microalbuminuria, fasting glycemia, and reduced nocturnal systolic BP decrease.

Conclusions:

• A blunted nocturnal decrease in blood pressure is independently associated with increased aortic stiffness in resistant hypertension.
• Older age, diabetes, microalbuminuria, low HDL-cholesterol, and widened 24-h pulse pressure are also independent correlates of aortic stiffness.