Relationship of ambulatory arterial stiffness index with blood pressure response to exercise in the early stages of hypertension

Dimitris Tsiachris, Costas Tsioufis, Kyriakos Dimitriadis, Peter Kokkinos, Charles Faselis, Dimitris Tousoulis, Andreas Michaelides, Vasilios Papademetriou, Christodoulos Stefanadis

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objectives: We sought to investigate the plausible interrelationship of exaggerated blood pressure response during exercise (EBPR) with ambulatory arterial stiffness index (AASI) in never-treated patients with uncomplicated essential hypertension. METHODS: Ninety-nine never-treated hypertensive patients (aged 50.7 years, 61 male) underwent 24 h ambulatory blood pressure (BP) recording, complete echocardiographic study and treadmill exercise testing and were classified as patients with (n=36) and without EBPR (n=63) based on the systolic BP elevation at peak exercise (≥210 mmHg for men and ≥190 mmHg for women). Arterial stiffness was evaluated by means of both AASI and pulse wave velocity (PWV). RESULTS: Hypertensives with EBPR, compared with those without EBPR, exhibited significantly higher 24 h systolic BP and pulse pressure (by 3.8 mmHg, P=0.041 and by 7.2 mmHg, P<0.001, respectively), and decreased peak early diastolic velocity and peak early diastolic velocity/peak atrial systolic velocity ratio (by 1.1 cm/s and by 0.11, both P<0.05, respectively). PWV and AASI values were higher in the EBPR group compared with the normal response group independently of confounders (by 0.9 m/s, P<0.001 and by 0.06, P=0.043, respectively). PWV (β=0.308, P=0.008) and 24-h pulse pressure (β=0.297, P=0.010), but not AASI, were independently associated with peak exercise systolic BP. Conclusion: EBPR constitutes a sign of premature cardiovascular stiffening in the setting of uncomplicated hypertension. The close relationship between EBPR and PWV but not AASI enhances the concept of PWV as a superior measure of arterial stiffness and constitutes an important factor in the interpretation of EBPR-linked cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalBlood Pressure Monitoring
Issue number3
StatePublished - Jun 2010
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialized Nursing


  • Ambulatory arterial stiffness index
  • Essential hypertension
  • Exercise testing
  • Pulse wave velocity


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