6A.05: THE PROGNOSTIC VALUE OF AMBULATORY ARTERIAL STIFFNESS INDEX AS A PREDICTOR OF CARDIOVASCULAR EVENTS IN RESISTANT HYPERTENSIVE XXXX ?

@entity1 @entity1187 @entity64 @entity712 @entity101 @entity25381 @entity943
OBJECTIVE: The prognostic value of ambulatory arterial stiffness index (AASI) is not well established in resistant @entity101 as much as in general population. Our aim was to evaluate, on resistant @entity101 @entity1 ( @entity25381 , the prognostic significance of AASI as an independent predictor of cardiovascular events (CV). DESIGN AND METHOD: Retrospective observational analysis of @entity25381 outpatients defined by abnormal 24h ambulatory blood pressure monitoring (24h ABPM) under 3 or more anti @entity101 drugs. The follow-up was defined since the first appointment until the 31st December 2014 or until a CV event ( @entity1187 , @entity64 , @entity712 or @entity943 ). RESULTS: Included 217 @entity1 , 119 male and 98 female, mean age 56,4+/- 14,6 years. During a mean follow-up of 6,0+/-3,1 years, 53 @entity1 (24,4%) had CV (5,1% acute coronary syndromes, 10,1% strokes and 9,2% acute @entity712 and @entity943 ). There were 24 deaths (50% cardiovascular and 50% non-cardiovascular). When analysed those with CV events versus without, those with events showed more frequently reverted dipper (22 % vs 12%) and extreme dipper patterns (10% vs 4,4%) X2 8,242 p<0.05)) and worse AASI (0.4918 vs 0,4046 p<0,02). In analysis of Kaplan Meier survival curves free of events those who were above median (cut off 0,41), of AASI had worse prognosis compared to those who were below it (Log Rank 8,347, p= 0.004) for CV event and (Log Rank 9,562, p=0,002) for global mortality. In a Cox hazard model adjusted for confounding factors ((sex, age, body mass index (BMI) and systolic blood pressure (SBP)) AASI was an independent predictor for CV event (HR 8,34; 95%CI 1,76-39,57; p 0,008) even when analysed in the same model with SBP night fall, 24h PP, and 24h SBP (HR 11,20; 95% CI 2,16 -58,15; p 0,004) and also for global mortality (HR 42,64; 95%CI 3,72-488,58; p 0,003). CONCLUSIONS: In this population AASI was the ABPM marker with the strongest predictor value for CV. Perhaps in resistant @entity101 AASI (traducing higher arterial stiffness) is a more potent CV predictor than in non resistant essential @entity101 .
