Visit-to-visit Blood Pressure Variability and Arterial Stiffness: Which Came First: The Chicken or the Egg?

Area of Science:

• Cardiovascular Medicine
• Gerontology
• Pharmacology

Background:

• Visit-to-visit blood pressure variability (VVV) is an independent risk factor for stroke in elderly patients with cardiovascular disease (CVD).
• Arterial remodeling, including in the carotid, coronary, and aortic arteries, may mediate the link between VVV and CVD incidence.
• VVV has been shown to predict the progression of arterial stiffness.

Purpose of the Study:

• To review the current literature on the relationship between VVV and coronary arterial remodeling.
• To explore the role of antihypertensive agents, specifically calcium channel blockers (CCBs), in modulating VVV and arterial stiffness.

Main Methods:

• Literature review of recent studies on VVV, arterial stiffness, arterial remodeling, and antihypertensive medications.
• Synthesis of evidence regarding the impact of CCBs on VVV and arterial stiffness in elderly hypertensive patients.

Main Results:

• VVV is a significant risk factor for stroke and predicts arterial stiffness progression.
• Long-acting CCBs are associated with reduced VVV and may decrease arterial stiffness.
• The relationship between VVV and coronary arterial remodeling has not been previously reviewed.

Conclusions:

• Strict blood pressure control with CCBs in elderly hypertensives may reduce VVV.
• This reduction in VVV could play a key role in suppressing arterial stiffening.
• CCB therapy may offer a strategy to mitigate CVD progression by managing VVV and arterial stiffness.