4.2 DO LEVEL AND VARIABILITY OF SYSTOLIC BLOOD PRESSURE PREDICT ARTERIAL PROPERTIES OR VICE VERSA?

DOI

10.1016/j.artres.2013.10.020How to use a DOI?

Abstract

Background. No longitudinal study addressed whether systolic blood pressure level (SBPL) or variability (SBPV) predict arterial properties or vice versa.

Methods and Results. In families randomly recruited from a Flemish population, we determined SBPL and SBPV from 5 consecutive blood pressure readings. The indexes of SBPv were variability independent of mean (VIM), the difference between maximum and minimum SBPL (MMD), and average real variability (ARV). We measured carotid intima-media thickness (cIMT) and distensibility (cD) by ultrasound and carotid-femoral pulse wave velocity (cfPWV) by tonometry (SphygmoCor, version 8.2). Effect sizes were computed for 1 SD increments in the predictors, while accounting for covariables and family clusters. Among 1171 participants (51.0% women; mean age, 39.8 years), followed up for 2.48 years (median), higher SBPL predicted (P≤0.036) higher cIMT (+14 μm), lower cD (–1.57 10-3/kPa) and faster cfPWV (+0.298 m/s) at follow-up, whereas none of the SBPV indexes predicted the arterial traits at follow-up (P≥0.11). In a subset of 749 participants, followed up for another 3.07 years, lower cD predicted (P≤0.026) higher SBPL (+1.69 mm Hg), VIM (+0.304 units), MMD (+1.05 mm Hg) and ARV (+0.389). Higher cfPWV predicted a 1.06 mm Hg increase SBPL (P = 0.027).

Conclusions. Temporality and effect size suggest that SBPL but not SBPV cause arterial stiffening and cIMT thickening. Carotid stiffening, independent of SBPL, predicts SBPV, possibly because baroreflexes originating from a stiffer carotid artery wall are impaired. Finally, stiffening of the aorta contributes to the age-related SBPL possibly because faster returning reflected waves augments SBPL.

Figure 1

Flow chart of participants1.

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TY  - JOUR
AU  - Yan-Ping Liu
AU  - Yu-Mei Gu
AU  - Lutgarde Thijs
AU  - Kei Asayama
AU  - Yu Jin
AU  - Lotte Jacobs
AU  - Tatiana Kuznetsova
AU  - Peter Verhamme
AU  - Luc Van Bortel
AU  - Harry A.J. Struijker-Boudier
AU  - Jan A. Staessen
PY  - 2013
DA  - 2013/11/11
TI  - 4.2 DO LEVEL AND VARIABILITY OF SYSTOLIC BLOOD PRESSURE PREDICT ARTERIAL PROPERTIES OR VICE VERSA?
JO  - Artery Research
SP  - 166
EP  - 167
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.020
DO  - 10.1016/j.artres.2013.10.020
ID  - Liu2013
ER  -