Arterial stiffness and blood pressure self-measurement with loaned equipment.

BACKGROUND A cross-sectional study was carried out in 415 hypertensive and normotensive subjects to determine the correlation between loaned self-measurement blood pressure (LSEM), arterial stiffness, and the different factors that contribute to it. METHODS The LSEM model consists of lending a number of sphygmomanometers, property of the clinic, to patients for 3-day periods. Arterial stiffness was evaluated using the carotid-to-femoral pulse wave velocity (PWV), using an automatic apparatus. To determine the importance of each of these factors, a multiple linear regression analysis was carried out. RESULTS Of the total number of patients, 78% were women, the average age was 57 +/- 12 years, 55.8% were hypertensive, and 38.8% were diabetic. The PWV average for the whole group was 12.1 +/- 4.2 m/sec. The correlation coefficients between the PVW and the self-measurements were 0.49 (P <.001) for the pulse pressure, and 0.46 (P <.001) for the systolic blood pressure (BP), respectively. Both represented 13.0 % of the total variation. The diastolic BP obtained by self-measurement and the serum creatinine values also had an effect on the stiffness, with 2.3 % (P =.05) each one. CONCLUSIONS The pulse pressure readings with self-measurement correlate better with the arterial stiffness, compared with the readings taken in the office.

[1]  R. Bauer,et al.  The Arterial System , 1978, Springer Berlin Heidelberg.

[2]  J. Blacher,et al.  Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients. , 1999, Hypertension.

[3]  A. Simon,et al.  Comparative effects of diabetes mellitus and hypertension on physical properties of human large arteries. , 1992, Journal of the American College of Cardiology.

[4]  S. Laurent,et al.  Aortic Stiffness Is an Independent Predictor of Primary Coronary Events in Hypertensive Patients: A Longitudinal Study , 2002, Hypertension.

[5]  R. Asmar,et al.  Racial differences in aortic stiffness in normotensive and hypertensive adults. , 1999, Journal of hypertension.

[6]  N. Fineberg,et al.  The influence of blood pressure and carbohydrate tolerance on vascular compliance in humans. , 2002, American journal of hypertension.

[7]  J. Goodwin,et al.  Spectrophotometry of proline in plasma and urine. , 1972, Clinical chemistry.

[8]  J. Mckenney,et al.  Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). , 2001, JAMA.

[9]  M. Safar,et al.  Large artery structure and function in hypertension and end‐stage renal disease , 1998, Journal of hypertension.

[10]  M E Safar,et al.  Pulse Pressure, Arterial Stiffness, and Drug Treatment of Hypertension , 2001, Hypertension.

[11]  J G Pipe,et al.  Pulse waveform analysis of arterial compliance: relation to other techniques, age, and metabolic variables. , 2000, American journal of hypertension.

[12]  M. Safar,et al.  The arterial system in hypertension. A prospective view. , 1995, Hypertension.

[13]  P. Zimmet,et al.  Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[14]  Pulse wave velocity as an index of arterial stiffness: a comparison between newly diagnosed (untreated) hypertensive and normotensive middle-aged Malay men and its relationship with fasting insulin. , 1999, Acta cardiologica.

[15]  W. Richmond Preparation and properties of a cholesterol oxidase from Nocardia sp. and its application to the enzymatic assay of total cholesterol in serum. , 1973, Clinical chemistry.

[16]  J. Ruidavets,et al.  Arterial stiffness and cardiovascular risk factors in a population-based study , 2000, Journal of hypertension.

[17]  J. Blacher,et al.  Impact of Aortic Stiffness Attenuation on Survival of Patients in End-Stage Renal Failure , 2001, Circulation.

[18]  R. Morfin,et al.  Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. , 1970, Journal of lipid research.

[19]  M E Safar,et al.  Pulse pressure and aortic pulse wave are markers of cardiovascular risk in hypertensive populations. , 2001, American journal of hypertension.

[20]  B. Pannier,et al.  Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. , 1995, Hypertension.

[21]  R. Troyo-Sanromán,et al.  Reproducibility and cost of blood pressure self‐measurement using the ‘Loaned Self‐measurement Equipment Model’ , 2001, Blood pressure monitoring.

[22]  P. Ducimetiere,et al.  Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients , 2001, Hypertension.

[23]  J. Cimas,et al.  Factores relacionados con la distensibilidad arterial en la hipertensión , 2000 .

[24]  A C Dornhorst,et al.  A prospective view. , 1975, Proceedings of the Royal Society of Medicine.

[25]  J. Ruidavets,et al.  Arterial stiffness and cardiovascular risk factors in a population-based study. , 2000 .

[26]  J. Pipe,et al.  Direct Magnetic Resonance Determination of Aortic Distensibility in Essential Hypertension: Relation to Age, Abdominal Visceral Fat, and In Situ Intracellular Free Magnesium , 1997 .

[27]  M. Safar,et al.  Arterial distensibility and ambulatory blood pressure monitoring in essential hypertension. , 1988, The American journal of cardiology.

[28]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.