Relationships Between Arterial Pressure-Volume Index and Cardiovascular Disease Biomarkers in Patients With Hypertension
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Updated: Sep 4, 2025
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Published on: September 27, 2024
1Hitsumoto Medical Clinic, Shimonoseki City, Yamaguchi 750-0025, Japan.
Insights
The arterial pressure-volume index (API) is a new marker for arterial stiffness. This study found API independently correlates with key cardiovascular disease biomarkers in hypertensive patients, suggesting its utility in CVD risk assessment.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Biomarker Discovery
Background:
- Arterial stiffness is a significant risk factor for cardiovascular disease (CVD).
- The arterial pressure-volume index (API) is a novel marker derived from conventional blood pressure measurements, indicating arterial stiffness.
- Hypertension is a primary condition associated with increased arterial stiffness and CVD risk.
Purpose of the Study:
- To investigate the relationship between the arterial pressure-volume index (API) and established cardiovascular disease (CVD) biomarkers in patients with hypertension.
- To assess the potential of API as an early indicator for CVD risk in hypertensive individuals.
- To identify optimal cut-off values for API in relation to specific CVD biomarkers.
Main Methods:
- A cross-sectional study involving 288 hypertensive patients undergoing pharmacological treatment without prior CVD.
- Automated calculation of the arterial pressure-volume index (API) using a commercial device.
- Correlation and multiple regression analyses were performed to assess relationships between API and CVD biomarkers, including urinary albumin, high-sensitivity troponin T, and skin autofluorescence. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off points.
Main Results:
- The arterial pressure-volume index (API) showed significant positive correlations with urinary albumin (r=0.42), high-sensitivity troponin T (r=0.39), and skin autofluorescence (r=0.41), all with P < 0.001.
- Multiple regression analysis confirmed that API independently predicted these CVD biomarkers.
- ROC analysis identified an API > 26 as an optimal cut-off for detecting elevated levels of urinary albumin, high-sensitivity troponin T, and skin autofluorescence, indicating increased CVD risk.
Conclusions:
- The arterial pressure-volume index (API) demonstrates an independent association with key cardiovascular disease biomarkers in hypertensive patients.
- An API value greater than 26 serves as a potential threshold for identifying individuals with elevated CVD risk markers.
- API shows promise as a valuable, non-invasive tool for assessing arterial stiffness and cardiovascular risk in hypertension management.
Background:
The arterial pressure-volume index (API), which is obtained by conventional blood pressure measurement, is a new marker for arterial stiffness. The aim of this study was to clarify the relationships between the API and various clinical parameters, including cardiovascular disease (CVD) biomarkers, in patients with hypertension for the prevention of CVD.
Methods:
This cross-sectional study enrolled 288 patients with hypertension receiving pharmacological treatment, without a history of CVD (males/females: 115/173; age: 63 ± 11 years (mean ± standard deviation)). The API was automatically calculated using a commercial device.
Results:
The API was significantly correlated with important CVD biomarkers, such as the concentration of urinary albumin (r = 0.42, P < 0.001), high-sensitivity troponin T (r = 0.39, P < 0.001), and skin autofluorescence (marker of advanced glycation end products in tissues) (r = 0.41, P < 0.001). Multiple regression analyses demonstrated that when the API was used as a subordinate factor, these biomarkers were independent variables. According to the receiver operating characteristic curve analysis, an API of > 26 is the optimal cut-off point for determining albuminuria as ≥ 30 mg/g Cr, high high-sensitivity cardiac troponin T concentration as ≥ 0.014 ng/mL, or high skin autofluorescence as ≥ 3.0 arbitrary unit (area under the curve = 0.703, 0.702, and 0.704; and P < 0.001, respectively).
Conclusion:
This investigation demonstrates that API had an independent relationship with relevant CVD biomarkers, such as urinary albumin, high-sensitivity troponin T, and skin autofluorescence. Additionally, the outcomes of receiver operating characteristic curve analysis are presented as values that an API > 26 defines for these biomarkers linked with the formation of CVD.
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