Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

Dirk G. Dechering, Marijke S. Van Der Steen, Ahmet Adiyaman, Lutgarde Thijs, Jaap Deinum, Yan Li, Eamon Dolan, Reinier P.M. Akkermans, Tom Richart, Tine W. Hansen, Masahiro Kikuya, Jiguang Wang, Eoin OBrien, Theo Thien, Jan A. Staessen

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


Background: We studied the repeatability of the ambulatory arterial stiffness index (AASI), which can be computed from 24-h blood pressure (BP) recordings as unity minus the regression slope of diastolic on systolic BP. Methods: One hundred and fifty-two hypertensive outpatients recruited in Nijmegen (mean age = 46.2 years; 76.3% with systolic and diastolic hypertension) and 145 patients enrolled in the Systolic Hypertension in Europe (Syst-Eur) trial (71.0 years) underwent 24-h BP monitoring at a median interval of 8 and 31 days, respectively. We used the repeatability coefficient, which is twice the SD of the within-participant differences between repeat recordings, and expressed it as a percentage of four times the SD of the mean of the paired measurements. Results: Mean AASI (crude or derived by time-weighted or robust regression) and 24-h pulse pressure (PP) were similar on repeat recordings in both cohorts. In Nijmegen patients, repeatability coefficients of AASI and PP were ∼50%. In Syst-Eur trial patients, repeatability coefficient was ∼60% for AASI and ∼40% for PP. For comparison, repeatability coefficients for 24-h systolic and diastolic BP were ∼30%. Differences in AASI between paired recordings were correlated with differences in the goodness of fit (r) of the AASI regression line as well as with differences in the night-to-day BP ratio. However, in sensitivity analyses stratified for type of hypertension, r, or dipping status, repeatability coefficients for AASI did not widely depart from 50 to 60% range. Conclusion: Estimates of mean AASI were not different between repeat recordings, and repeatability coefficients were within the 50-60% range.

Original languageEnglish
Pages (from-to)1993-2000
Number of pages8
JournalJournal of hypertension
Issue number10
Publication statusPublished - 2008 Oct
Externally publishedYes


  • ambulatory arterial stiffness index
  • ambulatory blood pressure monitoring
  • arterial stiffness
  • diurnal blood pressure profile
  • reproducibility

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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