Aortic stiffness and aortic-brachial stiffness mismatch as markers of renal dysfunction in hypertension

Figures & data

Table 1. Baseline characteristics according to eGFR group.

			eGFR ≥ 90		eGFR 89–60		eGFR 59–30		eGFR < 30
	All		ml/min × 1.73m^2		ml/min × 1.73m^2		ml/min × 1.73m^2		ml/min × 1.73m^2
n	107		39		31		32		4
Age, years	58 ± 13	23–87	51 ± 13.4	23–75	59 ± 9.6	36–76	65 ± 11.1	37–87	74 ± 1.7	72–76
Male sex	73	68	30	76.9	14	45.2	24	75,0	4
Heigt, cm	175.5 ± 8.8	156–196	176.6 ± 8.3	158–189	172 ± 8.3	157–196	178 ± 9.4	156–193	176 ± 9.6	170–190
Body mass index, kg/m^2	26.8 ± 4.3	19–49	26.7 ± 3.8	19–37	27.1 ± 5.7	20–49	26.4 ± 2.7	21.3–32	27.5 ± 5.1	22.5–33
Current smoking	6	5.6	1	2.6	2	6.5	2	7,1	0
CVD	10	9.3	0		1	3.2	7	21,9	2	50
SBP, mm Hg	149.1 ± 16.6	119–205	148.1 ± 14.0	127–205	154.0 ± 14.9	126–195	143.4 ± 18.7	119–183	168.0 ± 18.1	152–187
DBP, mm Hg	87.3 ± 10.1	67–135	89.6 ± 11.6	68–135	89.6 ± 9.2	67–103	81.6 ± 6.8	70–99	91.8 ± 2.5	89–95
Heart rate, bpm	58.3 ± 7.4	43–81	58.2 ± 7.0	43–74	59 ± 6.8	47–71	57 ± 7.3	46–72	65 ± 15.3	50–81
Onogoing anti-hypertensive medication	33	31	0		2	6.5	27	84,4	4	100
ACEi or ARB treatment	29	27	0		1	3.2	25	78,1	3	75
eGFR, ml/min × 1.73m^2	73.4 ± 27.4	21–130	100.4 ± 9.4	90–130	78.5 ± 7.9	62–89	41.9 ± 8.8	30–58	23.3 ± 2.1	21–26
ACR, mg/mmol	13.7 ± 38.8	0.2–282.5	0.78 ± 0.8	0.2–5.3	2.1 ± 5.6	0.2–29.2	36.1 ± 61.5	0.3–283	56.0 ± 56.0	16.3–136
Glucose, mmol/l	5.5 ± 0.6	4.4–7.5	5.4 ± 0.6	4.4–6.4	5.5 ± 0.6	4.7–7.5	5.5 ± 0.6	4.4–6.8	6.0 ± 1.1	4.8–7.3
Total cholesterol, mmol/l	5.1 ± 1.1	0.8–9.6	5.2 ± 0.9	3.5–7.3	5.6 ± 1.2	3.7–9.6	4.6 ± 1.1	0.8–7.0	5.3 ± 1.2	3.7–6.7
LDL cholesterol, mmol/l	3.3 ± 0.9	0.8–6.9	3.4 ± 0.9	2–5.2	3.6 ± 1.1	2.1–6.9	2.9 ± 0.8	0.8–4.4	3.0 ± 1.0	1.9–3.6

Mean values ± SD and range, or n and %; as appropriate. CVD, cardiovascular disease; SBP, systolic blood pressure; DBP, diastolic blood pressure; ACEi, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker, ACR, albumin creatinine ratio; LDL, low density lipoprotein.

Table 2. Circulatory measurements according to the eGFR group.

	All		eGFR ≥ 90 ml/min × 1.73 m^2		eGFR 89–60 ml/min × 1.73 m^2		eGFR 59–30 ml/min × 1.73 m^2		eGFR < 30 ml/min × 1.73 m^2
n	107		39		31		32		4		p
Central blood pressure
Central SBP, mm Hg	140 ± 19	106–200	137 ± 17	107–181	150 ± 14	122–200	134 ± 21	110–189	153 ± 25	138–182	ns
Central DBP, mm Hg	88 ± 10	69–133	90 ± 12	69–132	92 ± 8	74–105	82 ± 7	71–98	94 ± +2	92–96	0.04
Central PP, mm Hg	52 ± 14.8	29–99	47 ± 10.8	29–79	58 ± 13.4	32–97	52 ± 17.9	31–99	59 ± 23.0	45–86	0.08
Pulse wave analysis
cfPWV, m/s	9.4 ± 2.8	4.2–24.5	8.6 ± 1.5	4.2–11.2	9.0 ± 2.5	6.2–15	10.0 ± 2.6	5.5–15.3	14.3 ± 7.3	7.1–24.5	<0.001
crPWV, m/s	9.0 ± 1.2	5.5–11.4	9.0 ± 1.3	5.5–11.4	9.2 ± 1.2	6.8–11.3	8.7 ± 1.1	5.8–10.7	9.7 ± 1.3	8.4–11.1	ns
cfPWV/crPWV	1.0 ± 0.3	0.59–2.8	0.9 ± 0.1	0.7–1.3	1.0 ± 0.3	0.6–1.6	1.2 ± 0.3	0.6–1.6	1.5 ± 0.9	0.9–2.8	<0.001
Aix, mm Hg	30.3 ± 11.5	−7.5–54	27.1 ± 13.6	−7.5–54	35.5 ± 8.0	15.5–49.5	29.7 ± 10.7	8.0–48.5	28.7 ± 7.6	22.0–37.0	ns
Endotehelial and microvascular function
FMD, % increase	5.4 ± 4.2	−3–18.4	6.4 ± 4.2	0–18.4	4.9 ± 4.4	−3–13.5	4.4 ± 4.1	−2–16	6.5 ± 4.1	3–11	ns
SEVR, %	169.4 ± 30.3	104–251	175.1 ± 27.7	128–251	160 ± 26.4	104–221	170.8 ± 34.0	113–233	149.5 ± 23.9	122–165.5	ns
Echocardiographic indices
LVMI, g/m^2	105.9 ± 29.4	56.5–191.6	105.0 ± 30.7	60.0–160.5	104.7 ± 34.1	56.5–191.6	108.2 ± 25.4	60.4–187.8	106.9 ± 31.1	79.5–145.9	ns
Relative wall thickness	0.39 ± 0.09	0.20–0.60	0.37 ± 0.09	0.18–0.61	0.36 ± 0.08	0.24–0.53	0.42 ± 0.08	0.21–0.56	0.46 ± 0.05	0.40–0.52	0.001
E/A	1.1 ± 0.4	0.5–2.8	1.2 ± 0.5	0.5–2.8	1.0 ± 0.3	0.7–1.9	1.0 ± 0.3	0.6–1.9	1.1 ± 0.7	0.5–2	0.01
E/é	8.9 ± 2.4	4.6–17.5	8.1 ± 2.0	4.6–14.1	8.8 ± 1.8	6.2–12.6	9.7 ± 2.8	5.5–17.5	11.6 ± 2.7	8.5–15	<0.001
LAVI, ml/m^2	16.3 ± 5.0	1.4–36.5	15.8 ± 5.1	8.9–30.7	16.3 ± 5.3	9.2–36.5	16.7 ± 4.9	1.4–24.7	18.7 ± 5.1	14.4–24.7	ns

Mean values ± SD, and range; p by bivariate correlation. SBP, systolic blood pressure; DBP, diastolic blood pressure; PP, pulse pressure; cfPWV, carotid to femoral pulse wave velocity; crPWV, carotid to radial PWV; Aix, augmentation index; FMD, postischemic forearm flow mediated vasodilation; SEVR, subendocardial viability ratio; LVMI, left ventricular mass index; LAVI, left atrial volume index.

Figure 1. Relations between carotid-femoral pulse wave velocity (cfPWV) and eGFR. The solid regression line shows all 107 patients: bivariate correlation r = 0.40, p < 0.001; multivariate correlation slope = −1.9, R = 0.88, r = −0.20, p = 0.002. Broken line shows 74 patients without antihypertensive medication (only four cases had an eGFR <60 ml/min × 1.73m²), slope = −2.32, R = 0.58, r = −0.28 p = 0.08. The broken-dotted line shows 33 patients on antihypertensive medication (only two cases had a eGFR > 60 ml/min × 1.73m²), slope = −2.10, R = 0.63 r = −0.60, p = 0.003.

Figure 2. Relations between carotid-femoral pulse wave velocity (PWV) to carotid-radial PWV ratio (cfPWV/crPWV) and eGFR. The solid regression line shows all 107 patients: bivariate correlation r = 0.39, p < 0.001; multivariate correlation slope −14.8, R = 0.87, r = −0.16, p = 0.01. The broken line shows 74 patients without antihypertensive medication (only four cases had an eGFR <60 ml/min × 1.73 m²), slope = −19.3, R = 0.58, r = −0.23 p = 0.09. The broken-dotted line shows 33 patients on antihypertensive medication (only two cases had a eGFR > 60 ml/min × 1.73 m²), slope = −14.1, R = 0.50, r = −0.49 p = 0.03.

Figure 3. Relations between carotid to radial pulse wave velocity (crPWV) and eGFR. The solid regression line shows all 107 patients: bivariate correlation r = 0.07, p = 0.52, multivariate correlation slope = −1.47, R = 0.85, r = −0.07, p = 0.29. The broken line shows 74 patients without antihypertensive medication (only four cases with eGFR <60 ml/min × 1.73m²), slope = −0.28, R = 0.53, r = −0.02, p = 0.88. The broken-dotted line shows 33 patients on antihypertensive medication (only two cases with eGFR > 60 ml/min × 1.73m²), slope = −3.54, R = 0.35, r = −0.36, p = 0.18.