Artery Research

Volume 20, Issue C, December 2017, Pages 90 - 90

P106 AORTIC STIFFNESS AND CENTRAL SYSTOLIC PRESSURE ARE ASSOCIATED WITH ORTHOSTATIC HYPOTENSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Authors
Philip Rankin1, Nikesh Parekh2, Steve Holt3, 4, Chakravarthi Rajkumar2
1Brighton and Sussex University Hospitals Trust, Brighton, UK
2Brighton and Sussex Medical School, Brighton, UK
3The Royal Melbourne Hospital, Melbourne, Australia
4University of Melbourne, Melbourne, Australia
Available Online 6 December 2017.
DOI
10.1016/j.artres.2017.10.137How to use a DOI?
Abstract

Objective: Orthostatic hypotension (OH) is common cardiovascular problem affecting older adults, and is associated with falls, stroke and chronic kidney disease (CKD). This postural drop (PD) in blood pressure (BP) has been independently associated with increased aortic stiffness in older adults. Aortic stiffness is a modifiable cardiovascular risk factor, and measureable non-invasively. We investigated the association between OH, aortic stiffness and central aortic systolic pressure (CSP) in CKD patients (ACADEMIC cohort).

Design and method: Postural BP changes were measured in one-hundred and forty-six patients (mean age 68.6 SD±11.4, 75% male, 21% diabetic) using 24-hour-ambulatory blood pressure monitoring with postural sensing (Diasys Integra II®, Novacor, France). Patients were divided into those with systolic postural drop (SPD, n = 23, mean standing systolic BP < mean lying systolic BP) versus those without (n = 123).

Complior® (Artech Medical, France) measured aortic stiffness as carotid-femoral pulse wave velocity (cf-PWV) and peripheral arterial stiffness as carotid-radial PWV (cr-PWV). Sphygmocor® (Atcor, Australia) measured CSP and augmentation index (AI) from the radial artery.

Results: Cf-PWV and CSP were significantly higher in CKD patients with SPD versus those without (15.2m/s vs 12.7m/s, p < 0.001, 148 mmHg vs 136 mmHg, p = 0.012).

Multivariate logistic regression showed SBP remained significantly associated with aortic stiffness (p = 0.002, OR = 1.45 95%CI = 1.15–1.77) and CSP (p = 0.026, OR = 1.031, 95%CI = 1.00–1.06), independent of age, eGFR, diabetes, smoking pack-years, cholesterol, height and weight. RAI (32.1%vs28.9%, p = 0.093) and cr-PWV (11.0m/s vs 11.2m/s, p = 0.62) were not significantly different between groups.

Conclusion: Increased aortic stiffness and CSP are independently associated with OH. Stiff central arteries, rather than peripheral, contribute more to OH.

Open Access
This is an open access article distributed under the CC BY-NC license.

Journal
Artery Research
Volume-Issue
20 - C
Pages
90 - 90
Publication Date
2017/12/06
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2017.10.137How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Philip Rankin
AU  - Nikesh Parekh
AU  - Steve Holt
AU  - Chakravarthi Rajkumar
PY  - 2017
DA  - 2017/12/06
TI  - P106 AORTIC STIFFNESS AND CENTRAL SYSTOLIC PRESSURE ARE ASSOCIATED WITH ORTHOSTATIC HYPOTENSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE
JO  - Artery Research
SP  - 90
EP  - 90
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.137
DO  - 10.1016/j.artres.2017.10.137
ID  - Rankin2017
ER  -