Objective: To identify clinical and vascular parameters associated with increased augmentation index (Aix) in treated hypertensive patients.

Methods: Hypertensive patients, aged 30–74 years, were evaluated using high-resolution ultrasonography for brachial flow-mediated dilation (FMD), EndoPat 2000 for peripheral arterial tonometry and Sphygmocor to obtain central hemodynamic parameters. Vascular age was calculated after estimating Framingham risk score. Patients (n=177) were distributed into three equal groups (n=59 each) according to Aix values: 1st tertil (T1) Aix<28%, 2nd tertil (T2) Aix 28–37%, 3rd tertil (T3) Aix>37%.

Results: The mean age was not different among the groups (55±11 vs 57±10 vs 58±8 years). T3 group presented significant increase in brachial SBP (139±17 vs 145±17 vs 151±22 mmHg, p=0.006), aortic SBP (126±16 vs 138±17 vs 148±24 mmHg, p<0.001), and aortic pulse pressure (41±10 vs 49±14 vs 60±21 mmHg, p<0.001). Aix obtained by EndoPat (14±13 vs 30±19 vs 30±18 %, p<0.001) and vascular age (71±16 vs 77±13 vs 78±12 years, p=0.019) were significantly greater in T2 and T3 comparing to T1. There was no significant differences in endothelial function evaluated by brachial FMD (7.5±5.1 vs 8.9±5.5 vs 9.2±6.7 %) and through reactive hyperemia index by EndoPat (1.9±0.5 vs 2.2±0.7 vs 1.9±0.4 units). Aix was not correlated to age, but was significantly correlated to vascular age (r=0.22, p=0.005), brachial SBP (r=0.21, p=0.006) and to aortic SBP (r=0.40, p<0.001).

Conclusion: In this population of treated hypertension, increased vascular stiffness characterized by an elevated augmentation index was associated to increased vascular age but not with worse endothelial function.