Abstract 12018: Visit-to-Visit BP Variability and Progression of Carotid Artery Remodeling: A 4-Year Follow Up Study
Background: In the cross-sectional study, visit-to-visit blood pressure (BP) variability has been shown to be associated with artery remodeling. However, the relationship between visit-to-visit BP variability and progression of carotid artery remodeling was not clear. In this study, we prospectively investigated the relationship of visit-to-visit BP variability with carotid artery atherosclerosis and stiffness.
Methods: BP measurement and carotid ultrasound were performed in common carotid artery (CCA) in 164 elderly subjects (79.7 years old at baseline, female 75%) with one or more cardiovascular risks (hypertension, diabetes, hyperlipidemia, and smoking). Based on 12 visits (once a month), visit-to-visit BP variability (expressed as standard deviation [SD] and coefficient of variation [CV]; CV=SD/average value over 12 visits х100 [%]), maximum BP, minimum BP, and delta (maximum-minimum) BP were measured.
Results: In the 4.2 years follow-up, mean intima-media thickness (IMT) and stiffness parameter β were measured at baseline (1.03±0.3mm and 13.4±9.2, respectively) and at the follow-up (1.24±0.3mm and 13.4±5.1, respectively). In a multiple linear regression analysis, the maximum (B: 0.044, 95%CI: 0.004-0.08, p≤0.05), minimum (B: 0.06, 95%CI: 0.008-0.1, p≤0.05), SD (B: 0.21, 95%CI: 0.03-0.4, p≤0.05) and average (B: 0.07, 95%CI: 0.008-0.1, p≤0.05) in systolic BP (SBP) and SD in diastolic BP (B: 0.20, 95%CI: 0.02-0.4, p≤0.05) were significantly associated with stiffness parameter β at the follow-up after adjustment for age, smoking, lower HDL level, baseline stiffness parameter β and follow-up period. On the other hand, there were no significant associations between visit-to-visit BP variability measures and CCA mean IMT at follow-up.
Conclusion: In the high risk elderly at cardiovascular disease, exaggerated visit-to-visit BP variability as well as average BP level were significant predictors for carotid arterial stiffness. Visit-to-visit BP variability might predominantly associated with progression in arterial stiffness rather than with that in atherosclerosis, and thus might be useful markers to define the risk stratification in relation to artery remodeling.
- © 2013 by American Heart Association, Inc.