title: Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study.
abstract: In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. Based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit BP variability expressed as the standard deviation (s.d.), coefficient of variation (CV), maximum BP, minimum BP and delta (maximum-minimum) BP. We measured mean intima-media thickness (IMT) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. In a multiple regression analysis, the maximum, minimum, s.d. and average of systolic BP (SBP) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. There were no significant associations between the visit-to-visit BP variability measures and the change in mean IMT. Significant associations of maximum, minimum, s.d. and average SBP were found with increased β-values in the subjects without calcium channel blocker (CCB) use and in the subjects using renin-angiotensin system inhibitors (RASIs). Thus, exaggerated visit-to-visit SBP variability and a high average SBP level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without CCBs use and in those using a RASI.
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: M
authors.identifier: 0000-0002-3838-1369
authors.initials: M
authors.lastname: Nagai
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Dote
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Oda
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Kagawa
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Yamane
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kubo
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Higashihara
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
authors.forename: W
authors.initials: W
authors.lastname: Harada
authors.affiliation: Department of Internal Medicine, Shobara Red Cross Hospital, Hiroshima, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Masuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000187:drug effects*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies; D059289:Vascular Stiffness
chemical_list: D057911:Angiotensin Receptor Antagonists; D002121:Calcium Channel Blockers