Christina Antza1, Ioannis Doundoulakis1, Evagelos Akrivos2, Stella Stabouli3, Christina Trakatelli4, Michael Doumas5, Vasilios Kotsis1. 1. 3rd Department of Internal Medicine, Hypertension-24h Ambulatory Blood Pressure Monitoring Center, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece. 2. Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, Medical School, Aristotle University of Thessaloniki and 2nd Department of Internal Medicine, Thessaloniki, Greece. 3. 1st Department of Pediatrics, Hippokration Hospital, Aristotle University, Thessaloniki, Greece. 4. 3rd Department of Internal Medicine, Papageorgiou Hospital, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece. 5. Veterans Affairs Medical Center, George Washington University, Washington, DC, USA.
Abstract
BACKGROUND: This study compared the diagnostic accuracy of blood pressure (BP) measurement methods, office BP, ambulatory BP monitoring (ABPM), and home BP, in the identification of early vascular aging (EVA) and developed a score to predict the risk of EVA in hypertensive patients. METHODS: Two-hundred eighty-two consecutive subjects (39.7% male) aged 56.8 ± 15.8 years were included. Office and out-of-office BP measurements including ABPM on a usual working day and 7 days home BP monitoring were performed. Carotid-femoral pulse wave velocity (c-f PWV) was measured in all patients. EVA was defined as c-f PWV values higher than the expected for age average values according to European population data. RESULTS: In univariate analysis, EVA was significantly correlated with office systolic BP, average 24-hour systolic and diastolic BP, and average 24-hour and office heart rates. The area under the curve for predicting EVA was 0.624 (95% CI 0.551 to 0.697), 0.559 (95% CI 0.484 to 0.635) and 0.565 (95% CI 0.49 to 0.641), for daytime, home, and office systolic BP, respectively. Ambulatory BP variables, age, sex, body mass index, diabetes mellitus (yes/no), and estimated glomerular filtration rate were used to develop a new score for EVA providing a total accuracy of 0.82, 0.84 sensitivity, and 0.78 specificity. CONCLUSIONS: In conclusion, the new risk score, Early Vascular Aging Ambulatory score, may accurately identify hypertensive patients with EVA using ABPM values and classic cardiovascular risk factors.
BACKGROUND: This study compared the diagnostic accuracy of blood pressure (BP) measurement methods, office BP, ambulatory BP monitoring (ABPM), and home BP, in the identification of early vascular aging (EVA) and developed a score to predict the risk of EVA in hypertensivepatients. METHODS: Two-hundred eighty-two consecutive subjects (39.7% male) aged 56.8 ± 15.8 years were included. Office and out-of-office BP measurements including ABPM on a usual working day and 7 days home BP monitoring were performed. Carotid-femoral pulse wave velocity (c-f PWV) was measured in all patients. EVA was defined as c-f PWV values higher than the expected for age average values according to European population data. RESULTS: In univariate analysis, EVA was significantly correlated with office systolic BP, average 24-hour systolic and diastolic BP, and average 24-hour and office heart rates. The area under the curve for predicting EVA was 0.624 (95% CI 0.551 to 0.697), 0.559 (95% CI 0.484 to 0.635) and 0.565 (95% CI 0.49 to 0.641), for daytime, home, and office systolic BP, respectively. Ambulatory BP variables, age, sex, body mass index, diabetes mellitus (yes/no), and estimated glomerular filtration rate were used to develop a new score for EVA providing a total accuracy of 0.82, 0.84 sensitivity, and 0.78 specificity. CONCLUSIONS: In conclusion, the new risk score, Early Vascular Aging Ambulatory score, may accurately identify hypertensivepatients with EVA using ABPM values and classic cardiovascular risk factors.
Authors: Vasiliki Bikia; Terence Fong; Rachel E Climie; Rosa-Maria Bruno; Bernhard Hametner; Christopher Mayer; Dimitrios Terentes-Printzios; Peter H Charlton Journal: Eur Heart J Digit Health Date: 2021-10-18