title: Visit-to-visit and 24-h blood pressure variability: association with endothelial and smooth muscle function in African Americans.
abstract: The purpose of this study was to investigate the association of visit-to-visit and 24-h blood pressure (BP) variability with markers of endothelial injury and vascular function. We recruited 72 African Americans who were non-diabetic, non-smoking and free of cardiovascular (CV) and renal disease. Office BP was measured at three visits and 24-h ambulatory BP monitoring was conducted to measure visit-to-visit and 24-h BP variability, respectively. The 5-min time-course of brachial artery flow-mediated dilation and nitroglycerin-mediated dilation were assessed as measures of endothelial and smooth muscle function. Fasted blood samples were analyzed for circulating endothelial microparticles (EMPs). Significantly lower CD31+CD42- EMPs were found in participants with high visit-to-visit systolic blood pressure (SBP) variability or high 24-h diastolic blood pressure (DBP) variability. Participants with high visit-to-visit DBP variability had significantly lower flow-mediated dilation and higher nitroglycerin-mediated dilation at multiple time-points. When analyzed as continuous variables, 24-h mean arterial pressure variability was inversely associated with CD62+ EMPs; visit-to-visit DBP variability was inversely associated with flow-mediated dilation normalized by smooth muscle function and was positively associated with nitroglycerin-mediated dilation; and 24-h DBP variability was positively associated with nitroglycerin-mediated dilation. All associations were independent of age, gender, body mass index and mean BP. In conclusion, in this cohort of African Americans visit-to-visit and 24-h BP variability were associated with measures of endothelial injury, endothelial function and smooth muscle function. These results suggest that BP variability may influence the pathogenesis of CV disease, in part, through influences on vascular health.
authors.affiliation: 1] Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY, USA [2] Hypertension, Molecular, and Applied Physiology Laboratory, Department of Kinesiology, Temple University, Philadelphia, PA, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Diaz
authors.forename: P
authors.initials: P
authors.lastname: Veerabhadrappa
authors.forename: M A
authors.initials: MA
authors.lastname: Kashem
authors.forename: S R
authors.initials: SR
authors.lastname: Thakkar
authors.forename: D L
authors.initials: DL
authors.lastname: Feairheller
authors.forename: K M
authors.initials: KM
authors.lastname: Sturgeon
authors.forename: C
authors.initials: C
authors.lastname: Ling
authors.forename: S T
authors.initials: ST
authors.lastname: Williamson
authors.forename: J
authors.initials: J
authors.lastname: Kretzschmar
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.forename: H
authors.initials: H
authors.lastname: Grimm
authors.forename: D M
authors.initials: DM
authors.lastname: Babbitt
authors.forename: C
authors.initials: C
authors.lastname: Vin
authors.forename: X
authors.initials: X
authors.lastname: Fan
authors.forename: D L
authors.initials: DL
authors.lastname: Crabbe
authors.forename: M D
authors.initials: MD
authors.lastname: Brown
mesh_terms: D001741:Black or African American; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D001916:Brachial Artery / Q000503:physiopathology; D055252:Cell-Derived Microparticles / Q000378:metabolism; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005996:Nitroglycerin; D015143:Philadelphia / Q000453:epidemiology; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000097:blood; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000378:metabolism; D011237:Predictive Value of Tests; D013997:Time Factors; D014664:Vasodilation; D014665:Vasodilator Agents
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D019038:Platelet Glycoprotein GPIb-IX Complex; C546936:SELE protein, human; D014665:Vasodilator Agents; D005996:Nitroglycerin