The Relationship between the 24 h Blood Pressure Variability and Carotid Intima-Media Thickness: A Compared Study

Large blood pressure variability (BPV) will not only harm the target organ but also increase the possibility of the cardiovascular events. Since the damage of vascular system always leads to the alteration of the carotid wall, the structure and function of the carotid artery have been extensively examined in previous studies. In this work we conduct a study (60 subjects, aged 33–79) to evaluate the relationship between BPV and carotid intima-media thickness (IMT) in Shenzhen, which is one large city in the southern area of China. In our study, the blood pressure (BP) was collected using the 24 h ambulatory BP monitoring, and the BPV was evaluated using standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) during 24 h, daytime and nighttime. All the IMT measurements are collected by ultrasound. The results show that both the daytime, and 24 h systolic BPV evaluated by three indices are positively associated with IMT. Among them, daytime systolic BPV evaluated with ARV is the best variable to represent the increasing of carotid IMT. In addition, after adjusting by age, sex, smoking, hypertension, and mean BP and PP values, 24 h diastolic BPV evaluated with SD also presents the favorable performance.

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

[2]  Kazuomi Kario,et al.  Visit-to-visit blood pressure variations: new independent determinants for cognitive function in the elderly at high risk of cardiovascular disease , 2012, Journal of hypertension.

[3]  G. Schillaci,et al.  Lack of association between blood pressure variability and left ventricular mass in essential hypertension. , 1998, American journal of hypertension.

[4]  Jan A. Staessen,et al.  Blood pressure variability remains an elusive predictor of cardiovascular outcome. , 2009, American journal of hypertension.

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

[6]  G Parati,et al.  Blood pressure variability and organ damage. , 1994, Journal of cardiovascular pharmacology.

[7]  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.

[8]  Yan Li,et al.  Blood pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome , 2010, Hypertension Research.

[9]  Enzo Grossi,et al.  Measurements of carotid intima-media thickness and of interadventitia common carotid diameter improve prediction of cardiovascular events: results of the IMPROVE (Carotid Intima Media Thickness [IMT] and IMT-Progression as Predictors of Vascular Events in a High Risk European Population) study. , 2012, Journal of the American College of Cardiology.

[10]  R M Nerem,et al.  Oscillatory shear stress stimulates adhesion molecule expression in cultured human endothelium. , 1998, Circulation research.

[11]  José I. Recio-Rodríguez,et al.  Relationship of 24-h blood pressure variability with vascular structure and function in hypertensive patients , 2013, Blood pressure monitoring.

[12]  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.

[13]  Gianfranco Parati,et al.  Assessment and management of blood-pressure variability , 2013, Nature Reviews Cardiology.

[14]  Kazuomi Kario,et al.  Visit-to-visit and ambulatory blood pressure variability as predictors of incident cardiovascular events in patients with hypertension. , 2012, American journal of hypertension.

[15]  L H Kuller,et al.  Isolated systolic hypertension and subclinical cardiovascular disease in the elderly. Initial findings from the Cardiovascular Health Study. , 1992 .

[16]  Roberto Sega,et al.  Blood Pressure Variability and Organ Damage in a General Population: Results from the PAMELA Study , 2002 .

[17]  Yutaka Imai,et al.  Ambulatory Blood Pressure and 10-Year Risk of Cardiovascular and Noncardiovascular Mortality: The Ohasama Study , 2005, Hypertension.

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

[19]  Michael J Pencina,et al.  Common Carotid Artery Intima-Media Thickness Progression as a Predictor of Stroke in Multi-Ethnic Study of Atherosclerosis , 2011, Stroke.

[20]  J. Neaton,et al.  Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. , 1993, Archives of internal medicine.

[21]  Chen-Fang Chen,et al.  Twenty-four-hour ambulatory blood pressure and duration of hypertension as major determinants for intima-media thickness and atherosclerosis of carotid arteries. , 2006, Atherosclerosis.

[22]  G. Parati,et al.  Prognostic Value of Blood Pressure Variability and Average Blood Pressure Levels in Patients With Hypertension and Diabetes , 2013, Diabetes Care.

[23]  Efstathios Manios,et al.  Time Rate of Blood Pressure Variation Is Associated With Increased Common Carotid Artery Intima-Media Thickness , 2005, Hypertension.

[24]  G Mancia,et al.  Mechanisms and clinical implications of blood pressure variability. , 2000, Journal of Cardiovascular Pharmacology.

[25]  N. Zakopoulos,et al.  Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity. , 2012, Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.

[26]  W. Kannel,et al.  Elevated systolic blood pressure as a cardiovascular risk factor. , 2000, The American journal of cardiology.

[27]  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.

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

[29]  M. Kikuya,et al.  Prognostic Significance of Blood Pressure and Heart Rate Variabilities: The Ohasama Study , 2000, Hypertension.

[30]  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.

[31]  Ryusuke Inoue,et al.  Ambulatory blood pressure, blood pressure variability and the prevalence of carotid artery alteration: the Ohasama study , 2007, Journal of hypertension.

[32]  S D Moulopoulos,et al.  Effect of 24-hour blood pressure and heart rate variations on left ventricular hypertrophy and dilatation in essential hypertension. , 1990, American heart journal.

[33]  Paolo Verdecchia,et al.  Different Prognostic Impact of 24-Hour Mean Blood Pressure and Pulse Pressure on Stroke and Coronary Artery Disease in Essential Hypertension , 2001, Circulation.