title: Associations of aortic distensibility and arterial elasticity with long-term visit-to-visit blood pressure variability: the Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: BACKGROUND
  Although higher visit-to-visit variability (VVV) of blood pressure (BP) is associated with increased cardiovascular disease risk, the physiological basis for VVV of BP is incompletely understood.
  
  
  METHODS
  We examined the associations of aortic distensibility (assessed by magnetic resonance imaging) and artery elasticity indices (determined by radial artery pulse contour analysis) with VVV of BP in 2,640 and 4,560 participants, respectively, from the Multi-Ethnic Study of Atherosclerosis. Arterial measures were obtained at exam 1. BP readings were taken at exam 1 and at 3 follow-up visits at 18-month intervals (exams 2, 3, and 4). VVV was defined as the SD about each participant's mean systolic BP (SBP) across visits.
  
  
  RESULTS
  The mean SDs of SBP were inversely associated with aortic distensibility: 7.7, 9.9, 10.9, and 13.2mm Hg for quartiles 4, 3, 2, and 1 of aortic distensibility, respectively (P trend < 0.001). This association remained significant after adjustment for demographics, cardiovascular risk factors, mean SBP, and antihypertensive medication use (P trend < 0.01). In a fully adjusted model, lower quartiles of large artery and small artery elasticity (LAE and SAE) indices were also associated with higher mean SD of SBP (P trend = 0.02 for LAE; P trend < 0.001 for SAE).
  
  
  CONCLUSIONS
  In this multiethnic cohort, functional alterations of central and peripheral arteries were associated with greater long-term VVV of SBP.
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, New York, USA. ds2231@mail.cumc.columbia.edu
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Viera
authors.forename: Devin
authors.initials: D
authors.lastname: Mann
authors.forename: Jonathan
authors.initials: J
authors.lastname: Newman
authors.forename: Joao
authors.initials: J
authors.lastname: Lima
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000503:physiopathology*; D001158:Arteries / Q000503:physiopathology*; D050197:Atherosclerosis / Q000208:ethnology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D004548:Elasticity; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: arteries; blood pressure; epidemiology; hypertension; vasculature.
references.citation: Am J Epidemiol. 2010 Jan 1;171(1):63-71
references.pmid: 19951938
references.citation: Hypertension. 1999 Jun;33(6):1392-8
references.pmid: 10373222
references.citation: Vasc Med. 2007 Aug;12(3):183-8
references.pmid: 17848474
references.citation: J Am Soc Hypertens. 2011 May-Jun;5(3):184-92
references.pmid: 21531344
references.citation: Hypertension. 2011 Feb;57(2):160-6
references.pmid: 21200000
references.citation: Arterioscler Thromb Vasc Biol. 2003 Apr 1;23(4):554-66
references.pmid: 12615661
references.citation: Arch Neurol. 2010 May;67(5):564-9
references.pmid: 20457955
references.citation: Clin Auton Res. 1996 Jun;6(3):171-82
references.pmid: 8832127
references.citation: Am J Kidney Dis. 2012 Jan;59(1):41-9
references.pmid: 22000727
references.citation: Stroke. 2002 Nov;33(11):2626-30
references.pmid: 12411652
references.citation: Clin Sci (Lond). 2001 Apr;100(4):387-93
references.pmid: 11256976
references.citation: Am J Epidemiol. 2011 Sep 1;174(5):528-36
references.pmid: 21709134
references.citation: Lancet. 2010 Mar 13;375(9718):895-905
references.pmid: 20226988
references.citation: Hypertension. 2012 Jan;59(1):98-104
references.pmid: 22106403
references.citation: Am J Epidemiol. 2002 Nov 1;156(9):871-81
references.pmid: 12397006
references.citation: Hypertension. 1995 Sep;26(3):503-8
references.pmid: 7649589
references.citation: Blood Press Monit. 2010 Dec;15(6):312-5
references.pmid: 20890179
references.citation: Hypertension. 1988 Oct;12(4):380-7
references.pmid: 3169948
references.citation: Stroke. 2012 Mar;43(3):733-9
references.pmid: 22282885
references.citation: Hypertension. 2012 Aug;60(2):369-77
references.pmid: 22753222
references.citation: J Am Coll Cardiol. 2011 Apr 5;57(14):1511-22
references.pmid: 21453829
references.citation: Am J Hypertens. 2012 Sep;25(9):962-8
references.pmid: 22739805
references.citation: Am J Hypertens. 2009 Feb;22(2):137-44
references.pmid: 19057518
references.citation: Hypertension. 2007 Oct;50(4):617-22
references.pmid: 17698721
references.citation: Am J Epidemiol. 1997 May 1;145(9):771-6
references.pmid: 9143206
references.citation: Am J Epidemiol. 2011 Apr 15;173(8):898-905
references.pmid: 21422061
references.citation: Hypertens Res. 2012 Jan;35(1):55-61
references.pmid: 21814215
references.citation: Hypertension. 2010 Jan;55(1):26-32
references.pmid: 19933927
references.citation: J Hypertens. 2009 Mar;27(3):535-42
references.pmid: 19330913
references.citation: Hypertension. 2012 Sep;60(3):625-30
references.pmid: 22753206
references.citation: Am J Hypertens. 2005 Jan;18(1):65-71
references.pmid: 15691619
references.citation: Eur J Clin Invest. 2012 Mar;42(3):245-53
references.pmid: 21815887
references.citation: J Appl Physiol (1985). 2008 Nov;105(5):1652-60
references.pmid: 18772322