title: Time rate of blood pressure variation: a new factor associated with coronary atherosclerosis.
abstract: OBJECTIVE
  Previous studies have demonstrated that the time rate of blood pressure (BP) variation was associated with early carotid atherosclerosis, independent of peripheral and central BP levels. We evaluated the association between the rate of BP variation, derived from ambulatory BP monitoring (ABPM) data analysis, and the severity and topography of coronary artery lesion in a cohort of normotensive patients with suspected coronary artery disease.
  
  
  METHODS
  ABPM and coronary angiography were performed in 162 normotensive patients with suspected coronary artery disease. The topography and severity of coronary artery lesions were assessed by Gensini score. The time rate of BP variation was defined as the first derivative of the BP values against time.
  
  
  RESULTS
  Patients with coronary artery disease (n = 123) presented significantly (P = 0.005) higher daytime rate of systolic BP variation than control patients (n = 39). Multiple linear regression models revealed independent determinants of Gensini score in the following rank order: diabetes mellitus (β: +0.286, P < 0.001), daytime rate of systolic BP variation (β: +0.277, P < 0.001), daytime systolic BP (β: +0.216, P = 0.002), smoking (β: +0.178, P = 0.008) and hypercholesterolemia (β: +0.158, P = 0.020). A 0.1 mmHg/min increase in the daytime rate of systolic BP variation correlated with an increment of 4.935 in the Gensini score (95% CI 2.432-7.438).
  
  
  CONCLUSIONS
  Steeper BP variations may produce a greater stress on the arterial wall and may have an additive role to vascular risk factors and BP parameters in the detection of the severity of coronary artery lesions in normotensive individuals with suspected coronary artery disease.
authors: Department of Clinical Therapeutics, University of Athens, Greece.
authors: Efstathios
authors: E
authors: Manios
authors: Kimon
authors: K
authors: Stamatelopoulos
authors: Georgios
authors: G
authors: Tsivgoulis
authors: Gerasimos
authors: G
authors: Barlas
authors: Eleni
authors: E
authors: Koroboki
authors: Georgios
authors: G
authors: Tsagalis
authors: Fotios
authors: F
authors: Michas
authors: Konstantinos
authors: K
authors: Vemmos
authors: Nikolaos
authors: N
authors: Zakopoulos
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013995:Time