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Visit-to-visit blood pressure variability is a marker of cardiac diastolic function and carotid atherosclerosis
Rieko Okada1, Akira Okada, Takashi Okada
1Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. rieokada@med.nagoya-u.ac.jp.
Insights
High blood pressure variability is linked to poorer diastolic function and increased carotid atherosclerosis. This suggests visit-to-visit blood pressure fluctuations may be a risk factor for these conditions.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Diagnostic Imaging
Background:
- The relationship between visit-to-visit blood pressure (BP) variability and cardiac function, specifically diastolic function, remains unclear.
- The association between BP variability and the development of carotid atherosclerosis requires further investigation.
Purpose of the Study:
- To investigate the association between visit-to-visit systolic blood pressure variability and markers of cardiac function.
- To examine the link between visit-to-visit systolic blood pressure variability and carotid artery atherosclerosis.
Main Methods:
- 144 participants (80 female, mean age 73 years) underwent echocardiography and carotid ultrasonography.
- Systolic BP variability was assessed by standard deviation; participants were grouped into highest and lowest variability tertiles.
- Key metrics analyzed included E/e' (diastolic function), ejection fraction, left ventricular mass index (LVMI), and carotid max-IMT (atherosclerosis).
Main Results:
- Higher visit-to-visit BP variability was significantly associated with impaired diastolic function (higher E/e') after adjusting for covariates.
- Increased carotid intima-media thickness (max-IMT) was observed in individuals with high BP variability compared to those with low variability.
- No significant differences in left ventricular mass index (LVMI) or ejection fraction were found between the groups.
Conclusions:
- Elevated visit-to-visit blood pressure variability is associated with diastolic dysfunction.
- High blood pressure variability is linked to carotid atherosclerosis, suggesting it may be an independent risk factor.
- These findings highlight the clinical importance of monitoring BP variability in cardiovascular health.
Background:
The associations between visit-to-visit blood pressure (BP) variability and cardiac function and carotid atherosclerosis is not clear.
Methods:
Study subjects were 144 subjects (80 were female, aged 73 ± 9 years) who underwent echocardiography and cervical ultrasonography. The ratio of early ventricular filling velocity to early diastolic mitral annular velocity (E/e'), ejection fraction, left ventricular mass index (LVMI), and maximum intima-media thickness (max-IMT) of the carotid artery were compared between the highest (high variability) and lowest (low variability) tertiles of the standard deviation of systolic BP (9.9 ± 3.5 mmHg).
Results:
E/e' and max-IMT were significantly greater in the high variability group than in the low variability group after adjusting for age, sex, baseline systolic BP, and other covariates (high variability vs. low variability; E/e': 13.03 ± 5.33 vs. 10.66 ± 3.30, multivariate-adjusted difference (β) = 1.82, 95% confidence interval 0.06-3.58; max-IMT: 1.65 ± 0.43 mm vs. 1.42 ± 0.46 mm, β = 0.20 mm, 95% confidence interval 0.03-0.36 mm). There were no significant differences in LVMI or ejection fraction.
Conclusion:
These results indicate that high visit-to-visit BP variability is associated with diastolic function and carotid atherosclerosis, and is a possible risk factor for diastolic dysfunction and atherosclerosis.
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