[PP.06.11] ASSOCIATION BETWEEN AMBULATORY ARTERIAL STIFFNESS INDEX, MARKERS OF BLOOD PRESSURE VARIABILITY AND INDICES OF SUBCLINICAL VASCULAR DAMAGE IN OBESE CHILDREN. (September 2017)

• Record Type: Journal Article
• Authors: Tagetti, A.; Bonafini, S.; Minuz, P.; Fava, C.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523344.22271.2b
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Ambulatory Arterial Stiffness Index (AASI) and symmetric AASI (sAASI) have been proposed as indices of arterial stiffness easily obtained by 24-hour ambulatory blood pressure monitoring (ABPM). Moreover, ABPM allows the analysis of indices of BP variability such as day and night SD, nocturnal BP dipping, weighted 24-h SD (wSD), average real variability (ARV). The relationship between these indices and other markers of vascular subclinical damage has seldom been evaluated in children. Aim of the present study was to address this issue in a sample of obese children. Design and method: 45 obese children (27 males, 18 females), were included. Children underwent vascular measurements, including: (i) office and 24-hour ambulatory BP; (ii) brachial flow-mediated dilatation (FMD), carotid intima media thickness (cIMT), and distensibility (cDC) measured using ultrasound; and (iii) systemic arterial stiffness (SIDVP) measured using digital volume pulse analysis. From ABPM (if at least 70% of the programmed BP measurements were correctly recorded), we calculate AASI, sAASI, ARV, SD, SD, systolic and diastolic dipping and wSD. Results: ARV showed a significant correlation with SIDVP (r = 0.379; p = 0.023), index of systemic stiffness. AASI but not sAASI correlated with FMD (r = 0.361; p = 0.031), marker of endothelial function. In the population divided in hypertensive (n = 11)/normotensive (n = 34), on the basis of office BP values above 95th percentile according to sex and age, ARV was associated with SIDVP only in normotensive (r = 0.446; p = 0.015) but not in hypertensive children (rspearman = 0.000; p = 1). In normotensive, z score-BMI was correlated with both sAASI and wSD (respectively 0.340; p = 0.049 and 0.423; p = 0.014), wSD correlated with FMD (r = 0.384; p = 0.048); in hypertensive children, ARV correlated with FMD (r = 0.828; p = 0.011; rspearman = 0.738; p = 0.037). No indices of BP variability correlated with cIMT or cDC. Conclusions: BP variability, in particular ARV, shows a correlation with systemic but not local vascular stiffness in a sample of obese children, suggesting a relation between daily BP variability and arterial elastic properties. Some other relations between BP variability and endothelial function, were detectable only in the subgroups of children divided according to hypertensive status. Further studies, especially perspective ones, are needed to clarify the pathophysiological significance of these relations.