고혈압 환자에서 뇌졸중과 활동 동맥 경직도 및 혈압 일중변동의 연관성

Association of Stroke with Ambulatory Arterial Stiffness Index and Circardian Blood Pressure Variation in Hypertensive Patients

The Ambulatory arterial stiffness index (AASI) and abnormal dipping patterns have been suggested as a risk factor for stroke. Recent studies have reported that AASI might be confounded by dipping patterns as a prognostic marker. We conducted a retrospective analysis of the data of 869 hypertensive patients for evaluation of the association of stroke with AASI and dipping patterns. AASI was higher in patients with stroke than in patients without stroke (0.47±0.16 vs. 0.41±0.17; p=0.083) and inversely related with nocturnal systolic BP reduction (r=&#8211;0.21; p<0.001). In multiple linear regression analysis, independent predictors of AASI were 24-hour pulse pressure (β= 0.447, p<0.001) and nocturnal dipping (β=&#8211;0.178, p<0.001). The odds ratio (OR) for stroke associated with AASI was 0.86 (95% confidence interval (CI), 0.29&#8211;2.5; p=0.777) after multivariate adjustment. Higher OR was observed for non-dippers, extreme-dippers, and reverse-dippers than for dippers (OR 1.57; 95% CI 1.02&#8211;2.4, p=0.04, OR 2.71; 95% CI 1.06&#8211;6.88, p=0.037, OR 2.56; 95% CI 1.56&#8211;4.2, p<0.001, respectively). The results of this study show that dipping pattern has a stronger association with stroke than AASI in patients with hypertension.