title: Day-by-day variability in self-measured blood pressure at home: effects on carotid artery atherosclerosis, brachial flow-mediated dilation, and endothelin-1 in normotensive and mild-moderate hypertensive individuals.
abstract: OBJECTIVE
  To investigate variability in self-measured home blood pressure (HBP) and its effects on carotid artery atherosclerosis and endothelial function in normotensive and mild-moderate hypertensive individuals.
  
  
  METHODS
  This is a cross-sectional study. HBP monitoring over 7 consecutive days, carotid artery ultrasound, and brachial artery flow-mediated dilation (FMD) were performed in 314 normotensive, prehypertensive, and mild-moderate hypertensive volunteers. Variability in HBP was assessed by the SDs of the daily BP average of the last 6 consecutive days. The plasma endothelin-1 (ET-1) level was tested using an enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The tendency of SD of systolic HBP increased significantly from the normotension to the moderate hypertension group. SD of systolic HBP was significantly correlated with carotid intima-media thickness (IMT) (r=0.569, P<0.001), stiffness parameter β (r=0.447, P<0.001), FMD (r=-0.636, P<0.001), and ET-1 (r=0.649, P<0.001). SD of diastolic HBP was also correlated with carotid IMT, stiffness parameter β, FMD, and ET-1, but the strength of the correlation was weaker than SD of systolic HBP (all P<0.001). After adjustment of all covariants, SD of systolic HBP was always significantly associated with carotid IMT, stiffness parameter β, FMD, and ET-1.
  
  
  CONCLUSIONS
  Day-by-day variability in HBP increased with increasing BP level. This was significantly associated with carotid artery atherosclerosis and endothelial function in normotensive and mild-moderate hypertensive individuals. Day-by-day variability in HBP may serve as an important prognostic factor for atherosclerosis and endothelial dysfunction.
authors.affiliation: Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Shandong, China.
authors.forename: Zhendong
authors.initials: Z
authors.lastname: Liu
authors.forename: Yingxin
authors.initials: Y
authors.lastname: Zhao
authors.forename: Fanghong
authors.initials: F
authors.lastname: Lu
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.forename: Yutao
authors.initials: Y
authors.lastname: Diao
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D001916:Brachial Artery / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D059289:Vascular Stiffness / Q000502:physiology; D014664:Vasodilation / Q000502:physiology*
chemical_list: D019332:Endothelin-1