title: Relationship between short-term blood pressure variability and large-artery stiffness in human hypertension: findings from 2 large databases.
abstract: Short-term blood pressure (BP) variability predicts cardiovascular complications in hypertension, but its association with large-artery stiffness is poorly understood and confounded by methodologic issues related to the assessment of BP variations over 24 hours. Carotid-femoral pulse wave velocity (cfPWV) and 24-hour ambulatory BP were measured in 911 untreated, nondiabetic patients with uncomplicated hypertension (learning population) and in 2089 mostly treated hypertensive patients (83% treated, 25% diabetics; test population). Short-term systolic BP (SBP) variability was calculated as the following: (1) SD of 24-hour, daytime, or nighttime SBP; (2) weighted SD of 24-hour SBP; and (3) average real variability (ARV), that is, the average of the absolute differences between consecutive SBP measurements over 24 hours. In the learning population, all of the measures of SBP variability showed a direct correlation with cfPWV (SD of 24-hour, daytime, and nighttime SBP, r=0.17/0.19/0.13; weighted SD of 24-hour SBP, r=0.21; ARV, r=0.26; all P<0.001). The relationship between cfPWV and ARV was stronger than that with 24-hour, daytime, or nighttime SBP (all P<0.05) and similar to that with weighted SD of 24-hour SBP. In the test population, ARV and weighted SD of 24-hour SBP had stronger relationships with cfPWV than SD of 24-hour, daytime, or nighttime SBP. In both populations, SBP variability indices independently predicted cfPWV along with age, 24-hour SBP, and other factors. We conclude that short-term variability of 24-hour SBP shows an independent, although moderate, relation to aortic stiffness in hypertension. This relationship is stronger with measures of BP variability focusing on short-term changes, such as ARV and weighted 24-hour SD.
authors: Dipartimento di Medicina Clinica e Sperimentale, Università di Perugia, Perugia, Italy.
authors: Giuseppe
authors: G
authors: Schillaci
authors: Grzegorz
authors: G
authors: Bilo
authors: Giacomo
authors: G
authors: Pucci
authors: Stéphane
authors: S
authors: Laurent
authors: Isabelle
authors: I
authors: Macquin-Mavier
authors: Pierre
authors: P
authors: Boutouyrie
authors: Francesca
authors: F
authors: Battista
authors: Laura
authors: L
authors: Settimi
authors: Gaëlle
authors: G
authors: Desamericq
authors: Guillaume
authors: G
authors: Dolbeau
authors: Andrea
authors: A
authors: Faini
authors: Paolo
authors: P
authors: Salvi
authors: Elmo
authors: E
authors: Mannarino
authors: Gianfranco
authors: G
authors: Parati
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005263:Femoral Artery / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D059289:Vascular Stiffness / Q000502:physiology*