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Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study

Journal of Human Hypertension volume 31, pages 292–298 (2017)Cite this article

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Abstract

In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. Based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit BP variability expressed as the standard deviation (s.d.), coefficient of variation (CV), maximum BP, minimum BP and delta (maximum−minimum) BP. We measured mean intima-media thickness (IMT) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. In a multiple regression analysis, the maximum, minimum, s.d. and average of systolic BP (SBP) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. There were no significant associations between the visit-to-visit BP variability measures and the change in mean IMT. Significant associations of maximum, minimum, s.d. and average SBP were found with increased β-values in the subjects without calcium channel blocker (CCB) use and in the subjects using renin–angiotensin system inhibitors (RASIs). Thus, exaggerated visit-to-visit SBP variability and a high average SBP level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without CCBs use and in those using a RASI.

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Authors and Affiliations

  1. Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan

    M Nagai, K Dote, M Kato, S Sasaki, N Oda, E Kagawa, Y Nakano, A Yamane, Y Kubo, T Higashihara, S Miyauchi & W Harada

  2. Department of Internal Medicine, Shobara Red Cross Hospital, Hiroshima, Japan

    H Masuda

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  1. M Nagai
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  2. K Dote
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  3. M Kato
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Correspondence to M Nagai.

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Nagai, M., Dote, K., Kato, M. et al. Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study. J Hum Hypertens 31, 292–298 (2017). https://doi.org/10.1038/jhh.2016.77

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  • DOI: https://doi.org/10.1038/jhh.2016.77

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