Determinants of the ambulatory arterial stiffness index in 7604 subjects from 6 populations

Ahmet Adiyaman, Dirk G. Dechering, José Boggia, Yan Li, Tine W. Hansen, Masahiro Kikuya, Kristina Björklund-Bodegård, Tom Richart, Lutgarde Thijs, Christian Torp-Pedersen, Takayoshi Ohkubo, Eamon Dolan, Yutaka Imai, Edgardo Sandoya, Hans Ibsen, Jiguang Wang, Lars Lind, Eoin O'Brien, Theo Thien, Jan A. Staessen

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)


The ambulatory arterial stiffness index (AASI) is derived from 24-hour ambulatory blood pressure recordings. We investigated whether the goodness-of-fit of the AASI regression line in individual subjects (r 2) impacts on the association of AASI with established determinants of the relation between diastolic and systolic blood pressures. We constructed the International Database on the Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes (7604 participants from 6 countries). AASI was unity minus the regression slope of diastolic on systolic blood pressure in individual 24-hour ambulatory recordings. AASI correlated positively with age and 24-hour mean arterial pressure and negatively with body height and 24-hour heart rate. The single correlation coefficients and the mutually adjusted partial regression coefficients of AASI with age, height, 24-hour mean pressure, and 24-hour heart rate increased from the lowest to the highest quartile of r2. These findings were consistent in dippers and nondippers (night:day ratio of systolic pressure ≥0.90), women and men, and in Europeans, Asians, and South Americans. The cumulative z score for the association of AASI with these determinants of the relation between diastolic and systolic blood pressures increased curvilinearly with r2, with most of the improvement in the association occurring above the 20th percentile of r2 (0.36). In conclusion, a better fit of the AASI regression line enhances the statistical power of analyses involving AASI as marker of arterial stiffness. An r 2 value of 0.36 might be a threshold in sensitivity analyses to improve the stratification of cardiovascular risk.

Original languageEnglish
Pages (from-to)1038-1044
Number of pages7
Issue number6
Publication statusPublished - 2008 Dec
Externally publishedYes


  • Ambulatory arterial stiffness index
  • Arterial stiffness
  • Blood pressure measurement/monitoring
  • Epidemiology
  • Population science
  • Statistical analysis

ASJC Scopus subject areas

  • Internal Medicine


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