Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population

Whether elevated beat-to-beat blood pressure variability (BPV) has an influence on vascular elasticity is confounded and poorly understood. This study hypothesized that the increased BPV could have an adverse effect on the vascular elasticity, as estimated by total arterial compliance (TAC), independent of blood pressure (BP) values. Beat-to-beat BP and TAC were measured in 81 hypertensive patients (experimental population) and in 80 normal adults (control population). Beat-to-beat BPV was assessed by standard deviation (SD), average real variability (ARV), residual standard deviation (RSD) and variation independent of mean (VIM). In experimental population, systolic BPV (SBPV) showed a significant correlation with TAC (SD, r = −0.326, p < 0.001; ARV, r = −0.277, p = 0.003; RSD, r = −0.382, p < 0.001; VIM, r = −0.274, p = 0.003); similarly, SD, RSD and VIM of diastolic BP (DBP) also showed explicit correlation with TAC (r = −0.255, p = 0.006; r = −0.289, p = 0.002; r = −0.219, p = 0.019; respectively). However, in the control population, neither SBPV nor diastolic BPV (DBPV) showed a significant correlation with TAC. Furthermore, in the experimental population, VIM of systolic BP (SBP) was also a determinant of TAC (β = −0.100, p = 0.040) independent of average SBP, DBP, age and body mass index. In conclusion, these data imply that beat-to-beat BPV, especially SBPV, shows an independent correlation with vascular elasticity in hypertensive population.

[1]  Beat-to-beat, reading-to-reading, and day-to-day blood pressure variability in relation to organ damage in untreated Chinese , 2014 .

[2]  G Parati,et al.  Relation between blood pressure variability and carotid artery damage in hypertension: baseline data from the European Lacidipine Study on Atherosclerosis (ELSA) , 2001, Journal of hypertension.

[3]  B. Conrad,et al.  Relationship Between Circadian Blood Pressure Patterns and Progression of Early Carotid Atherosclerosis: A 3-Year Follow-Up Study , 2000, Circulation.

[4]  J. J. Settels,et al.  Physiocal, calibrating finger vascular physiology for finapres , 1995 .

[5]  A. Dart,et al.  Systemic Arterial Compliance is Decreased in Newly-Diagnosed Patients with Coronary Heart Disease: Implications for Prediction of Risk , 1996, Journal of cardiovascular risk.

[6]  E. O’Brien,et al.  Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension , 2010, The Lancet.

[7]  T. Marwick,et al.  Measurement of arterial distensibility and compliance to assess prognosis. , 2010, Atherosclerosis.

[8]  V. Kotsis,et al.  Arterial stiffness and SBP variability in children and adolescents , 2015, Journal of hypertension.

[9]  Yves Lecarpentier,et al.  Total arterial compliance estimated by stroke volume-to-aortic pulse pressure ratio in humans. , 1998, American journal of physiology. Heart and circulatory physiology.

[10]  P Segers,et al.  Use of pulse pressure method for estimating total arterial compliance in vivo. , 1999, American journal of physiology. Heart and circulatory physiology.

[11]  J. V. van Lieshout,et al.  Non‐invasive pulsatile arterial pressure and stroke volume changes from the human finger , 2005, Experimental physiology.

[12]  G. Mensah,et al.  Stroke volume/pulse pressure ratio and cardiovascular risk in arterial hypertension. , 1999, Hypertension.

[13]  Roberto Sega,et al.  Blood pressure variability and organ damage in a general population: results from the PAMELA study (Pressioni Arteriose Monitorate E Loro Associazioni). , 2002, Hypertension.

[14]  F. Cuccurullo,et al.  Blood pressure variability and cardiovascular risk in treated hypertensive patients. , 2006, American journal of hypertension.

[15]  Lu Zhang,et al.  Beat-to-Beat, Reading-to-Reading, and Day-to-Day Blood Pressure Variability in Relation to Organ Damage in Untreated Chinese , 2014, Hypertension.

[16]  A. Seifalian,et al.  Arterial elastic properties and cardiovascular risk/event. , 2002, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[17]  Giacomo Pucci,et al.  Relationship Between Short-Term Blood Pressure Variability and Large-Artery Stiffness in Human Hypertension: Findings From 2 Large Databases , 2012, Hypertension.

[18]  J. Cohn,et al.  Age-related abnormalities in arterial compliance identified by pressure pulse contour analysis: aging and arterial compliance. , 1999, Hypertension.

[19]  J R Jansen,et al.  Computation of aortic flow from pressure in humans using a nonlinear, three-element model. , 1993, Journal of applied physiology.

[20]  R. de Caterina,et al.  Awake Systolic Blood Pressure Variability Correlates With Target-Organ Damage in Hypertensive Subjects , 2007, Hypertension.

[21]  B. Haluska,et al.  A comparison of methods for assessing total arterial compliance , 2010, Journal of Human Hypertension.

[22]  Salvador A. Pintos,et al.  A reliable index for the prognostic significance of blood pressure variability , 2005, Journal of hypertension.

[23]  E. O’Brien,et al.  Prognostic Value of Reading-to-Reading Blood Pressure Variability Over 24 Hours in 8938 Subjects From 11 Populations , 2010, Hypertension.

[24]  Eoin O'Brien,et al.  Effects of β blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke , 2010, The Lancet Neurology.

[25]  Pascal Verdonck,et al.  Pulse Pressure Method and the Area Method for the Estimation of Total Arterial Compliance in Dogs: Sensitivity to Wave Reflection Intensity , 1999, Annals of Biomedical Engineering.

[26]  T. Marwick,et al.  Pulse pressure vs. total arterial compliance as a marker of arterial health , 2005, European journal of clinical investigation.

[27]  V. Melenovský,et al.  Impact of chronic changes in arterial compliance and resistance on left ventricular ageing in humans , 2015, European journal of heart failure.

[28]  D. P. Veerman,et al.  Relationship of steady state and ambulatory blood pressure variability to left ventricular mass and urinary albumin excretion in essential hypertension. , 1996, American journal of hypertension.

[29]  G Parati,et al.  Relationship of 24-hour blood pressure mean and variability to severity of target-organ damage in hypertension. , 1987, Journal of hypertension.

[30]  Gianfranco Parati,et al.  Assessment and management of blood-pressure variability , 2014, Nature Reviews Cardiology.

[31]  R. Heitmar Total arterial compliance: the future of cardiovascular risk assessment? , 2010, Journal of Human Hypertension.

[32]  Orestis Vardoulis,et al.  On the Estimation of Total Arterial Compliance from Aortic Pulse Wave Velocity , 2012, Annals of Biomedical Engineering.

[33]  J. Staessen,et al.  Within-Subject Blood Pressure Level—Not Variability—Predicts Fatal and Nonfatal Outcomes in a General Population , 2012, Hypertension.