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Title: Ambulatory arterial stiffness index and 24-hour ambulatory pulse pressure as predictors of mortality in Ohasama, Japan
Authors: Kikuya, Masahiro ×
Staessen, Jan A
Ohkubo, Takayoshi
Thijs, Lutgarde
Metoki, Hirohito
Asayama, Kei
Obara, Taku
Inoue, Ryusuke
Li, Yan
Dolan, Eamon
Hoshi, Haruhisa
Hashimoto, Junichiro
Totsune, Kazuhito
Satoh, Hiroshi
Wang, Ji-Guang
O'Brien, Eoin
Imai, Yutaka #
Issue Date: Apr-2007
Publisher: Lippincott Williams & Wilkins
Series Title: Stroke vol:38 issue:4 pages:1161-6
Abstract: BACKGROUND AND PURPOSE: Ambulatory arterial stiffness index (AASI) and pulse pressure (PP) are indexes of arterial stiffness and can be computed from 24-hour blood pressure recordings. We investigated the prognostic value of AASI and PP in relation to fatal outcomes. METHODS: In 1542 Ohasama residents (baseline age, 40 to 93 years; 63.4% women), we applied Cox regression to relate mortality to AASI and PP while adjusting for sex, age, BMI, 24-hour MAP, smoking and drinking habits, diabetes mellitus, and a history of cardiovascular disease. RESULTS: During 13.3 years (median), 126 cardiovascular and 63 stroke deaths occurred. The sex- and age-standardized incidence rates of cardiovascular and stroke mortality across quartiles were U-shaped for AASI and J-shaped for PP. Across quartiles, the multivariate-adjusted hazard ratios for cardiovascular and stroke death significantly deviated from those in the whole population in a U-shaped fashion for AASI, whereas for PP, none of the HRs departed from the overall risk. The hazard ratios for cardiovascular mortality across ascending AASI quartiles were 1.40 (P=0.04), 0.82 (P=0.25), 0.64 (P=0.01), and 1.35 (P=0.03). Additional adjustment of AASI for PP and sensitivity analyses by sex, excluding patients on antihypertensive treatment or with a history of cardiovascular disease, or censoring deaths occurring within 2 years of enrollment, produced confirmatory results. CONCLUSIONS: In a Japanese population, AASI predicted cardiovascular and stroke mortality over and beyond PP and other risk factors, whereas in adjusted analyses, PP did not carry any prognostic information.
URI: 
ISSN: 0039-2499
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hypertension and Cardiovascular Epidemiology
× corresponding author
# (joint) last author

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