老年高血压患者肱动脉收缩压与无创中心动脉收缩压的差异研究

目的通过对老年高血压患者的肱动脉收缩压(brachial aortic systolic blood pressure,bSBP)与中心动脉收缩压(central aortic systolic blood pressure,cSBP)的比较和差异分析,探讨有效控制患者血压的护理方法。方法用无创中心动脉压测量仪对1 194例老年高血压患者进行肱动脉血压和中心动脉压测量,将患者的bSBP与cSBP进行比较,并进行差异性分析。结果老年高血压患者的bSBP比cSBP低,差异有统计学意义(P0.05)。80岁以下老年高血压患者的bSBP与cSBP比较,差异无统计学意义(P0.05),而80岁以上老年高血压患者的bSBP明显低于cSBP,差异有统计学意义(P0.05)。1 194例老年高血压患者中,有37.19%患者的bSBP比cSBP高;有58.37%患者的bSBP比cSBP低;其中有26.55%患者的bSBP与cSBP之差在±1.33kPa(10mmHg)以上。只有4.44%患者的bSBP与cSBP相等。结论老年高血压患者肱动脉压和无创中心动脉压之间差异有统计学意义(P0.05),80岁以上患者的bSBP明显比其cSBP低,临床上应根据每位患者bSBP与cSBP的差异,采取个体化的护理干预措施。     

中心动脉血压变异性与高血压左心房扩大的关系

目的探讨中心动脉血压变异性与高血压左心房扩大的关系。方法入选原发性高血压136患者,行24 h动态血压监测(采用Mobil-O-Graph NG动态血压监测仪测量中心动脉及肱动脉血压变异性)和超声心动图检查。结果高血压左心房扩大患者46例(33.8%),与左心房正常的高血压患者相比,左心房扩大高血压患者脉压增大;24 h肱动脉收缩压标准差、24 h中心动脉收缩压标准差增大。经血压校正后回归分析显示24 h中心动脉收缩压标准差与高血压左心房扩大相关,而24 h肱动脉收缩压标准差未达显著性。结论左心房扩大的高血压患者肱动脉、中心动脉收缩压变异性增高,中心动脉收缩压变异性可能与左心房扩大相关。     

老年高血压患者认知功能损害与血压变异性、昼夜动脉血压情况、脉压指数的相关性

目的探讨老年高血压患者认知功能损害与血压变异性、昼夜动脉血压情况、脉压指数的相关性。方法选取老年高血压患者200例,对所有患者进行简易智力状态检查量表(MMSE)检查,根据评分结果分为对照组(认知功能正常) 80例与观察组(认知功能受损) 120例。分析老年高血压患者的动态血压参数、昼夜血压节律性变化、脉压指数(PPI)、左室质量指数(LVMI)、血清胱抑素C(Cys C)以及踝肱指数对认知功能的影响。结果 2组患者性别、年龄、病程、体质量指数(BMI)、心率(HR)等一般资料比较,差异无统计学意义(P 0. 05)。对照组MMSE评分为(28. 23±1. 14)分,显著高于观察组的(22. 23±3. 14)分(P 0. 05)。观察组平均收缩压(SBP)、白昼平均收缩压(DSBP)、夜间平均收缩压(NSBP)、脉压(PP)、PPI指标显著高于对照组(P 0. 05); 2组患者平均舒张压(DBP)、白昼平均舒张压(DDBP)、夜间平均舒张压(NDBP)比较,差异无统计学意义(P 0. 05)。观察组昼夜节律比为(10. 31±4. 19)%,颈动脉内膜中层厚度(IMT)为(0. 85±0. 34) mm,与对照组的昼夜节律比(16. 73±3. 85)%及IMT(0. 67±0. 21) mm比较,差异有统计学意义(P 0. 05)。对照组与观察组杓型、非杓型患者比例比较,差异有统计学意义(P 0. 05)。观察组LVMI、Cys C高于对照组,踝肱指数低于对照组,差异有统计学意义(P 0. 05)。相关性分析结果显示,MMSE评分与SBP、DSBP、NSBP、PP、PPI呈显著负相关(r=-0. 925、-0. 867、-0. 914、-0. 867、-0. 927,P 0. 05或P 0. 01),与DBP、DDBP、NDBP无显著相关性(P 0. 05)。结论老年高血压患者的认知功能受昼夜动脉血压情况、LVMI、血清Cys C、脉压指数以及踝肱指数等因素影响。针对老年高血压患者,应采取积极有效的措施控制血压及脉压指数,防止血压昼夜节律异常,逆转动脉粥样硬化,从而延缓认知功能损害的发生、发展。     

有创中心动脉脉压对老年冠状动脉Gensini评分的影响研究

目的观察有创主动脉及桡动脉血压对老年冠心病Gensini评分的影响。方法选取同期行冠状动脉造影的老年高血压患者162例,根据冠状动脉狭窄程度将患者分为正常组(狭窄<50%)、冠心病组(狭窄≥50%)。冠状动脉造影时同时测定中心动脉压及外周动脉压,根据冠状动脉造影结果进行Gensini评分,并观察各种血压参数和冠状动脉病变严重程度之间的关系。结果冠心病组患者中心动脉脉压较正常组要大,差异有统计学意义[(74.4±27.4)mmHg vs.(69.5±26.2)mmHg,P<0.05],中心动脉脉压与冠状动脉Gensini评分有正相关性(r=0.316,P=0.007),中心动脉脉压和年龄有正相关性(r=0.462,P=0.005),冠状动脉Gensini评分和年龄有正相关性(r=0.298,P=0.013)。结论随着年龄增加,中心动脉脉压增大,增大的中心动脉脉压同冠状动脉粥样硬化病变程度有明显正相关性,可预测冠心病病变程度。     

胫前动脉压与肱动脉压对比观察

选择血压在正常范围，无影响血压之疾病及未服用影响血压药物者２００例，其中男１００例，女１００例，分别测量肱动脉压，胫前动脉压。结果显示：男性左胫前动脉收缩压与舒张压较左肱动脉收缩压高，女性差异无性显著性。右胫前动脉收缩压与舒张压与右肱动脉收缩压与舒张压经统计学处理，差异无显著性。     

肝移植术后早期桡动脉与股动脉有创血压的差异研究

目的探讨肝移植术后早期患者桡动脉与股动脉有创血压监测的差异性。方法选择2015年1月至2015年12月间我院重症医学科收治的肝移植术后患者22例,对肝移植术后入ICU当时至术后1天内8个时间点,同步进行桡动脉和股动脉有创血压监测。根据股动脉收缩压水平分为3组:A组,收缩压(systolic blood pressure,SBP)90~140 mm Hg(1 mm Hg=0.133 k Pa);B组,SBP140 mm Hg;C组,SBP90 mm Hg,测量桡动脉与股动脉有创血压的差值。结果当股动脉收缩压在正常范围内,股动脉与桡动脉的收缩压、舒张压及平均动脉压无明显差异,差异无统计学意义(P0.05);当股动脉收缩压90 mm Hg时,股动脉的收缩压及平均动脉压明显高于桡动脉压,差异有统计学意义(P0.05);当股动脉收缩压140 mm Hg时,股动脉收缩压明显小于桡动脉,差异有统计学意义(P0.05)。结论肝移植术后患者早期低血压及高血压状态下,桡动脉与股动脉有创血压存在较大差异,低血压状态下桡动脉血压监测易低估患者实际血压水平,而高血压状态下表现为高估患者血压水平。     

老年高血压病的不同血压参数变异度与左室肥厚的关系

目的探讨老年高血压患者动态血压各参数变异度及脉压与左室肥厚的关系。方法采用动态血压、超声心动图检查 82例年龄大于 60岁的原发性高血压患者 ,其中 5 1例无左室肥厚 ,31例有左室肥厚 ,对两组动态血压参数进行组间比较及昼夜间比较 ,并对各参数与左室质量指数 ( L VMI)进行相关性分析。结果 1昼、夜收缩压水平、脉压与 LVMI呈强相关 ,左室肥厚组的收缩压、舒张压水平及脉压明显高于无左室肥厚组 ;2两组之间血压变异无差异 ;3所有病例收缩压变异大于舒张压变异 ,收缩压变异白昼大于夜间 ,而昼夜间舒张压变异、脉压水平改变不明显。结论老年高血压患者左室肥厚与血压变异相关性较小 ,主要与收缩压水平与脉压水平相关 ,老年高血压患者 2 4小时舒张压变异与脉压水平处于相对恒定的水平 ,脉压可能是预测老年高血压性左室肥厚的一个简便易行的指标。     

脉压指数与新疆维吾尔族原发性高血压左心室舒张功能的相关性研究

目的 探讨脉压指数(PPI)与新疆维吾尔族原发性高血压患者左心室舒张功能的关系.方法 106例经外周肱动脉压力测定收缩压(SBP)、舒张压(DBP),以PPI≤0.40和＞0.40分为两组进行分析.比较两组左心形态、左心室收缩功能和舒张功能情况.结果 PPI＞0.40组左心房内径明显增大(P＜0.05);左心室内径无明显改变(P＞0.05);室间隔、左心室后壁明显增厚,E/A值降低(P＜0.05),而左心室射血分数差异无显著性(P＞0.05).结论 对于新疆维吾尔族原发性高血压患者来说,高血压可导致左心形态发生改变,以左心房内径增大、室间隔及左心室后壁增厚为主要特征;左心室舒张功能异常出现早于左心室收缩功能异常.PPI＞0.40提示新疆维吾尔族原发性高血压患者早期合并有舒张功能障碍.     

社区护理干预对临界高血压老年患者血压的影响研究

对2013年1~12月在我院就诊的100例老年临界高血压患者的临床资料行回顾性分析,根据随机数字表分为干预组、对照组各50例,干预组在对照组治疗基础上,加行社区护理干预,比较两组干预6个月后的血压情况。结果组内比较:较之护理干预前,护理干预6个月后两组老年患者的收缩压、舒张压均明显下降,差异有统计学意义(P0.05)。组间比较:两组护理干预前的收缩压、舒张压比较,差异无统计学意义(P0.05),但护理干预6个月后,干预组老年患者的收缩压、舒张压明显低于对照组,差异有统计学意义(P0.05)。社区护理干预有助于老年患者的临界高血压恢复正常,值得深究推广。     

社区护理干预对临界高血压老年患者血压的影响

目的观察社区护理干预对临界高血压老年患者血压的影响效果。方法对40例临界高血压老年患者采用社区护理干预，内容包括知识教育和心理指导，并比较社区护理干预前后临界高血压老年患者血压变化情况。结果社区护理干预前后临界高血压老年患者收缩压和舒张压比较，P〈O．05，差异有统计学意义。结论社区护理干预可有效控制临界高血压老年患者的血压，并能改善临界高血压老年患者的不良情绪。     

动态动脉硬化指数与血压变异性的关系

目的 研究原发性高血压患者的动态动脉硬化指数(Ambulatory arterial stiffness index,AASI)与血压变异性(blood pressure variability,BPV)的关系.方法 随机选择120例原发性高血压患者进行动态血压监测,测定BPV、AASI.结果 AASI与24小时平均收缩压(r=0.231,P＜0.001)、24小时舒张压标准差(r=-0.132,P＜0.01)、24小时收缩压变异性(r=-0.13,P＜0.01)、24小时舒张压变异性(r=-0.21,P＜0.01)及勺型血压(r=-0.13,P＜0.01)有明显的相关性.AASI与24小时平均收缩压(β=0.018,P＜0.001)、24小时舒张压标准差(β=-0.011,P＜0.01)、24小时收缩压变异性(β=0.036,P＜0.01)、24小时舒张压变异性(β=-0.01,P＜0.01)、勺型血压(β=-0.15,P＜0.01)、及左心室质量指数(β=0.022,P=0.034)之间有线性回归关系.结论 AASI与BPV之间有明显的相关性.     

102例危重病患者有创血压和无创血压的对比

目的比较102例危重病患者有创血压（IBP）和无创血压（NBP）测量结果的一致性。 方法收集2016年3~9月在西安交通大学第二附属医院重症医学科住院治疗的102例危重病患者的尺/桡动脉IBP和同侧上臂NBP数据1072对,先对所有数据分别按收缩压、舒张压、脉压（PP）和平均动脉压（MAP）进行配对t检验;再将数据分为高血压组（MAP≥107 mmHg）（1 mmHg=0.133 kPa）、正常血压组（70 mmHg≤MAP<107 mmHg）和低血压组（MAP<70 mmHg）三个亚组,分别进行IBP和NBP的收缩压、舒张压、PP以及MAP间的配对t检验。以P<0.05为差异具有统计学意义。 结果有创收缩压和无创收缩压之间比较,差异具有统计学意义［（128.08±35.48）mmHg vs（122.56±24.84）mmHg,t=7.896,P<0.001）］;有创舒张压和无创舒张压之间比较,差异具有统计学意义［（65.66±13.69）mmHg vs（67.98±13.31）mmHg,t=-8.294,P<0.001］;有创PP和无创PP之间比较,差异具有统计学意义［（62.42±28.93）mmHg vs（54.58±20.00）mmHg,t=11.697,P<0.001］;有创MAP和无创MAP之间比较,差异无统计学意义［（86.47±18.94）mmHg vs（86.17±15.33）mmHg,t=0.867,P=0.386］。亚组分析显示高血压组（n=254）：有创收缩压和无创收缩压之间比较,差异具有统计学意义［（163.75±33.93）mmHg vs（152.16±16.78）mmHg,t=6.52,P<0.001］,有创舒张压和无创舒张压之间比较,差异具有统计学意义［（79.17±11.03）mmHg vs（83.69±9.50）mmHg,t=-6.85,P<0.001）］,有创PP和无创PP之间比较,差异具有统计学意义［（84.57±31.50）mmHg vs （68.47±20.72）mmHg,t=9.76,P<0.001］;正常血压组（n=687）：有创收缩压和无创收缩压之间比较,差异具有统计学意义［（122.66±24.74）mmHg vs（118.70±15.14）mmHg,t=5.071,P<0.001）］,有创舒张压和无创舒张压之间比较,差异具有统计学意义［（63.97±10.34）mmHg vs（65.60±8.49）mmHg,t=-5.049,P<0.001）］,有创PP和无创PP之间比较,差异具有统计学意义［（58.69±23.05）mmHg vs （53.10±11.90）mmHg,t=7.682,P<0.001］;低血压组（n=131）：有创收缩压和无创收缩压之间比较,差异无统计学意义［（87.35±24.33）mmHg vs（85.41±11.99）mmHg,t=1.109,P=0.269］,有创舒张压和无创舒张压之间比较,差异具有统计学意义［（48.32±8.27）mmHg vs（49.98±8.06）mmHg,t=-2.073,P=0.040］,有创PP和无创PP之间比较,差异具有统计学意义［（39.03±24.00）mmHg vs（35.43±13.97）mmHg,t=1.806,P<0.001］。 结论有创收缩压大于无创收缩压、有创舒张压小于无创舒张压、有创PP大于无创PP,而有创MAP等于无创MAP。采用MAP数值较采用收缩压和（或）舒张压数值可以消除IBP和NBP测量之间的差异。     

老年患者动脉弹性功能与围术期血压的相关性

目的：研究老年患者动脉弹性功能与围术期血压变化的关系。方法：随机选择68例ASA分级Ⅰ-Ⅱ级行全麻手术的老年患者,根据检查所得动脉弹性的结果分为四组,分别是A组（C1、C2均正常）,B组（C1异常,C2正常）,C组（C1正常,C2异常）,D组（C1、C2均异常）。测量其术前血压及全麻诱导8分钟后的血压水平。结果：动脉弹性功能不良的患者其术前MAP较高,且全麻诱导以后血压波动的比例较大。结论：高血压病的老年患者动脉弹性功能普遍降低;动脉弹性下降的老年病人全麻诱导后血压波动较大。     

Arterial blood pressure during early sepsis and outcome

Objective  To evaluate the association between arterial blood pressure (ABP) during the first 24 h and mortality in sepsis. Design  Retrospective cohort study. Setting  Multidisciplinary intensive care unit (ICU). Patients and participants  A total of 274 septic patients. Interventions  None. Measurements and results  Hemodynamic, and laboratory parameters were extracted from a PDMS database. The hourly time integral of ABP drops below clinically relevant systolic arterial pressure (SAP), mean arterial pressure (MAP), and mean perfusion pressure (MPP = MAP − central venous pressure) levels was calculated for the first 24 h after ICU admission and compared with 28-day-mortality. Binary and linear regression models (adjusted for SAPS II as a measure of disease severity), and a receiver operating characteristic (ROC) analysis were applied. The areas under the ROC curve were largest for the hourly time integrals of ABP drops below MAP 60 mmHg (0.779 vs. 0.764 for ABP drops below MAP 55 mmHg; P ≤ 0.01) and MPP 45 mmHg. No association between the hourly time integrals of ABP drops below certain SAP levels and mortality was detected. One or more episodes of MAP < 60 mmHg increased the risk of death by 2.96 (CI 95%, 1.06–10.36, P = 0.04). The area under the ROC curve to predict the need for renal replacement therapy was highest for the hourly time integral of ABP drops below MAP 75 mmHg. Conclusions  A MAP level ≥ 60 mmHg may be as safe as higher MAP levels during the first 24 h of ICU therapy in septic patients. A higher MAP may be required to maintain kidney function. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

脓毒症患者血流动力学数值与动脉压力波形关系的探讨

目的 :探讨脓毒症患者血流动力学数值与动脉压力波形变化的特征 ,以指导临床监护。方法 :对 37例脓毒症患者采用 Swan Ganz导管同时进行血流动力学及动脉压的连续监测与观察。结果 :疾病早期血流动力学数值尚属正常时 ,有 91.9%的患者出现动脉压力波形中降中峡提前出现于收缩期 ;在患者处于脓毒症期时波形为“高排低阻”型 ,当患者处于垂危阶段时波形为“低排高阻”型。而且脓毒症患者血流动力学各数值的变化在其动脉压波形上也会出现相应的改变。结论 :血流动力学与动脉压力波形的变化对预测脓毒症的发生和发展过程有指导意义     

Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome

Purpose

We compared blood pressure (BP) measurements obtained using radial artery applanation tonometry with invasive BP measurements using a catheter placed in the abdominal aorta through the femoral artery in patients with multiple organ dysfunction syndrome (MODS).

Materials and Methods

In 23 intensive care unit patients with MODS, we simultaneously assessed BP values for 15 minutes per patient using radial artery applanation tonometry (T-Line TL-200pro device; Tensys Medical Inc, San Diego, Calif) and the arterial catheter (standard-criterion technique). A total of 2879 averaged 10-beat epochs were compared using Bland-Altman plots.

Results

The mean difference ± SD (with corresponding 95% limits of agreement) between radial artery applanation tonometry–derived BP and invasively assessed BP was + 1.0 ± 5.5 mm Hg (− 9.9 to + 11.8 mm Hg) for mean arterial pressure, − 3.3 ± 11.2 mm Hg (− 25.3 to + 18.6 mm Hg) for systolic arterial pressure, and + 4.9 ± 7.0 mm Hg (− 8.8 to + 18.6 mm Hg) for diastolic arterial pressure, respectively.

Conclusions

In intensive care unit patients with MODS, mean arterial pressure and diastolic arterial pressure can be determined accurately and precisely using radial artery applanation tonometry compared with central aortic values obtained using a catheter placed in the abdominal aorta through the femoral artery. Although systolic arterial pressure could also be derived accurately, wider 95% limits of agreement suggest lower precision for determination of systolic arterial pressure.     

The effect of exercise on large artery haemodynamics in healthy young men

BACKGROUND: Brachial blood pressure predicts cardiovascular outcome at rest and during exercise. However, because of pulse pressure amplification, there is a marked difference between brachial pressure and central (aortic) pressure. Although central pressure is likely to have greater clinical importance, very little data exist regarding the central haemodynamic response to exercise. The aim of the present study was to determine the central and peripheral haemodynamic response to incremental aerobic exercise. MATERIALS AND METHODS: Twelve healthy men aged 31 +/- 1 years (mean +/- SEM) exercised at 50%, 60%, 70% and 80% of their maximal heart rate (HRmax) on a bicycle ergometer. Central blood pressure and estimated aortic pulse wave velocity, assessed by timing of the reflected wave (T(R)), were obtained noninvasively using pulse wave analysis. Pulse pressure amplification was defined as the ratio of peripheral to central pulse pressure and, to assess the influence of wave reflection on amplification, the ratio of peripheral pulse pressure to nonaugmented central pulse pressure (PPP : CDBP-P1) was also calculated. RESULTS: During exercise, there was a significant, intensity-related, increase in mean arterial pressure and heart rate (P < 0.001). There was also a significant increase in pulse pressure amplification and in PPP : CDBP-P(1) (P < 0.001), but both were independent of exercise intensity. Estimated aortic pulse wave velocity increased during exercise (P < 0.001), indicating increased aortic stiffness. There was also a positive association between aortic pulse wave velocity and mean arterial pressure (r = 0.54; P < 0.001). CONCLUSIONS: Exercise significantly increases pulse pressure amplification and estimated aortic stiffness.     

新生儿动脉血氧饱和度与经皮血氧饱和度对临床的指导意义

目的比较新生儿动脉血氧饱和度(SaO2)与标本采集前病儿在安静状态下所测的经皮血氧饱和度(SpO2)两种监测结果的异同,探索联合观察两种结果对临床的指导意义。方法方便性抽样选取2010年6-12月慈溪市人民医院新生儿重症监护病房患儿42例,对其SaO2与血气标本采集前SpO2作对照观察。结果当动脉血氧分压高于90mmHg(1mmHg=0.133kPa)时,两种方法氧饱和度值相对一致(P>0.05)。当血氧分压低于90mmHg时,SpO2高于SaO2;随着氧分压下降,两者差距越加明显。SpO2范围与发生SaO2<85%的概率分别为:低于85%时占100%;85%～95%时占30.3%;>95%时占0.7%。结论新生儿SaO2和SpO2的结果随氧分压变化而呈现不同,观察两者间距有助于判断患儿对缺氧的耐受程度及对氧疗时高血氧的识别。动脉血标本的采集会使部分患儿的氧饱和度下跌致安全范围以下,当患儿原本处于低氧状态时,氧饱和度下跌更加明显,临床上应加以重视。     

On the dynamic performance of the Abbott Safeset blood-conserving arterial line system

Objective. Critically ill patients frequently have indwelling arterial lines placed during their Intensive Care Unit stay. The lines are used to monitor blood pressure continuously, administer drugs and to draw blood for a variety of physiologic tests. Several blood-conserving arterial line systems have been developed to eliminate the need to discard blood in the process of obtaining undiluted and uncontaminated blood samples. The purpose of this study was to evaluate the dynamic performance of one such system – the Abbott Clinical Care System Safeset blood conserving arterial line system – in comparison to a conventional arterial line system. Methods. We studied ninety-nine patients who had indwelling arterial lines placed during surgery and who were admitted to our Surgical Intensive Care Unit (SICU). The patients were randomly placed into one of two groups. The control group received a conventional indwelling arterial line system; the experimental group received the Abbott Safeset system. We measured the damping coefficient and resonant frequency daily in order to evaluate and compare the dynamic performance of the two systems. We also measured discard volumes (in the control group) and blood sample sizes during the patients stays in the SICU. Results. The two patient groups were similar in regards to demographics and baseline clinical characteristics. A median 3 ml of blood per draw and 17.5 ml of blood per patient was discarded in purging the conventional arterial line system while, by design, no blood was discarded with the experimental system. There was no difference between the two groups with regard to damping coefficient. Both systems were underdamped. However, the conventional arterial line system had a significantly higher resonant frequency (16.7 Hz) compared to the Safeset system (12.5 Hz). Conclusions. Because the Abbott Safeset blood-conserving arterial line system is underdamped and has a lower resonant frequency compared to the traditional arterial system, it may overestimate systolic blood pressure, particularly in patients with high heart rates.     

Predicting arterial stiffness with ambulatory blood pressure: an 11-year follow-up

No prospective data have been published on whether ambulatory blood pressure (BP) works better than casual measurements in predicting arterial stiffness. This study with 11-year follow-up was launched to evaluate the usefulness of ambulatory intra-arterial BP in predicting pulse wave velocity (PWV). Ninety-seven previously healthy men were recruited from a routine physical check-up at baseline. BP was measured with standard cuff and intra-arterial ambulatory methods. Sixty-seven subjects with no antihypertensive medication were enrolled for a visit after a follow-up of 11 years. Arterial stiffness was estimated with PWV derived with impedance cardiography. Ambulatory 24-h systolic blood pressure (SBP) (r = 0.30, P = 0.01), 24-h mean arterial pressure (r = 0.27, P = 0.03), 24-h pulse pressure (r = 0.27, P = 0.03) and daytime SBP (r = 0.26, P = 0.03) were the best BP variables in predicting future PWV. Casual BP values did not bear significant correlations with future PWV. In hierarchical regression analysis, the best predictive value for future PWV was achieved with the model including ambulatory 24-h SBP, smoking (number of cigarettes) and age (adjusted R(2) = 0.26). In conclusion, to our knowledge, this is the only prospective follow-up study to show that ambulatory BP is superior to casual BP measurement in predicting future PWV.