Abstract 16106: Impact of Visit-to-Visit Systolic Blood Pressure Variability on Coronary Artery Atherosclerosis in Hypertensive Patients Without Known Coronary Artery Disiease
Introduction: Visit-to-visit variability in systolic blood pressure (SBP) has been reported as a risk of long-term cardiovascular events in hypertensive patients. However, a little has been known that the effect of visit-to-visit SBP variability in the presence of the severity and extent of coronary artery disease (CAD).
Hypothesis: Visit-to-visit SBP variability, as well as mean SBP, may be associated with the severity and extent of coronary artery atherosclerosis in hypertensive patients.
Methods: We analyzed consecutive 697 hypertensive patients who underwent computed tomography coronary angiography (CTCA) for the evaluation of CAD. Visit-to-visit variability in SBP was measured by the coefficient of variation (CV) of SBP (CVSBP) obtained at 6-clinic visits before CTCA. CTCA stenosis severity was categolized as no CAD, non-obstructive CAD (less than 50% diameter stenosis), and obstructive CAD (more than 50% diameter stenosis). The extent of CAD was categolized as non-extensive (less than 4 segments) or extensive (more than 4 segments) CAD based on the number of segments with atherosclerotic plaques.
Results: CTCA detected non-obstructive CAD in 33%, obstructive CAD in 43%, and extensive CAD in 37% of patients. In the higher quartiles of SBPCV, the incidence of obstructive CAD (5.7%, 13%, 13%, 10%, respectively, p<0.01) and extensive CAD (4.8%, 11%, 9.9%, 11%, respectively, p<0.001) increased compared with the lowest quartile. In multivariate analysis, the presence of diabetes, chronic kidney disease, higher age, and both larger mean SBP and CVSBP were independent predictors of the presence of obstructive CAD and extensive CAD (Table).
Conclusions: This study demonstrated that visit-to-visit variability in SBP was associated with the severity of CAD in patients with hypertention, independent from clinical atherosclerotic risk factors.
Author Disclosures: K. Otsuka: None. S. Fukuda: None. A. Tanaka: None. K. Nakanishi: None. H. Taguchi: None. K. Shimada: None. M. Yoshiyama: None.
- © 2014 by American Heart Association, Inc.