Abstract 13622: Association Between Arterial Stiffness and Variability of Home Blood Pressure Measurements
Background: Variability of blood pressure (BP) is known as a prognostic value for the subsequent target organ damage in hypertensive patients. Arterial stiffness is a risk factor for cardiovascular morbidity and mortality. The relationship between the arterial stiffness and the BP variability has been controversial. The objective of the present study was to investigate the relationship between arterial stiffness and home BP variability in patients with pre-hypertension (pre-HTN) and hypertension (HTN).
Methods: 463 patients (252 males, 49±12 year-old) were enrolled. Using radial applanation tonometry, by pulse wave analysis (PWA) was performed for evaluation of systemic arterial stiffness. All patients underwent both home BP measurements and PWA. Patients were asked to measure their seated BP once every morning within 1 hour of waking, and once every evening 1 hour before going to bed, after more than 2 minutes of rest each time. Home BP variability was calculated as the standard deviation (SD) of 7 HBP measurements. Among these patients, 329 patients underwent 24-hour ambulatory BP monitoring (ABPM) for evaluating the additional effects of circadian variability. Multiple linear regression analysis was performed to estimate and test the independent effects of home BP variability on the arterial stiffness.
Results: Mutivariate analysis showed that both systolic and diastolic morning BP variabilities were correlated with arterial stiffness expressed as augmentation pressure (AP, β=1.538, p=0.01 and β=1.374, p=0.035). The SDs of systolic and diastolic of evening were also associated with AP (β=1.565, p=0.01 and β=1.397, p=0.036). The SDs of morning and evening systolic BP were associated with augmentation index (AI, β=2.37, p=0.02 and β=2.402, p=0.001) and heart rate (75bpm) adjusted AI (β=2.099, p=0.01 and β=2.115, p=0.001). No statistical difference between circadian BP variability and arterial stiffness was demonstrated.
Conclusion: In present study, the variability of systolic BP was closely related with arterial stiffness in patients with HTN and pre-HTN. The home BP variability might be more significant indicator of arterial stiffness than circadian BP variability.
- © 2013 by American Heart Association, Inc.