P11.16 BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH AORTIC STIFFNESS AND TROPONIN-T IN PATIENTS WITH CKD STAGES 3 AND 4
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Introduction: Clinic blood pressure predicts future cardiovascular risk but variability of systolic blood pressure (SBP) may be closely associated with adverse outcomes. Increased variability of SBP may be due to loss of buffering capacity in the aorta through increased vascular stiffness. This may be important in chronic kidney disease (CKD) where patients have accelerated aortic stiffening and high cardiovascular mortality. However, the relationship between aortic stiffness and BP variability in patients with CKD has not previously been studied.
Methods: 150 patients with CKD stages 3–4 in a prospective study of cardiovascular risk underwent 24-hour ambulatory blood pressure (24h-ABPM) and measurement of aortic pulse wave velocity (aPWV). Serum Troponin-T (TnT) was measured using a high-sensitivity assay.
| Subject characteristics (n=150) | |
|---|---|
| Age (years) | 69±11 |
| Male gender (%) | 73 |
| Systolic (mmHg) | 150±20 |
| Diastolic BP (mmHg) | 81±11 |
| Diabetic (%) | 22 |
| Cardiovascular disease (%) | 39 |
| eGFR (mL/min/1.73m2) | 32±11 |
Results: Standard deviation of 24h-ABPM SBP was associated with age (rho=0.28,p<0.001), clinic SBP (rho=0.20,p=0.01), heart rate (rho=0.30,p<0.001), aPWV, (rho=0.22, P<0.01) and TnT (rho=0.26,p=0.001). SD 24h-ABPM was higher among diabetics (16vs18mmHg, p<0.05) and people with previous cardiovascular disease (15vs18mmHg, p=0.001). There was no significant difference in SD of 24h-ABPM SBP between people treated with different antihypertensive drugs or total number of antihypertensives taken. In stepwise multivariable analysis, factors independently associated with SD 24h-ABPM SBP were heart rate, cardiovascular disease and TnT (R2=0.18,p<0.001).
Conclusion: Aortic stiffness is associated with blood pressure variability. However, may be due to the association of cardiovascular disease with aortic stiffness rather than a causal mechanism.
Cite this article
TY - JOUR AU - L.A. Tomlinson AU - M.L. Ford AU - E.R. Smith AU - S.G. Holt AU - C. Rajkumar PY - 2011 DA - 2011/11/29 TI - P11.16 BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH AORTIC STIFFNESS AND TROPONIN-T IN PATIENTS WITH CKD STAGES 3 AND 4 JO - Artery Research SP - 196 EP - 196 VL - 5 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2011.10.172 DO - 10.1016/j.artres.2011.10.172 ID - Tomlinson2011 ER -