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Association of blood pressure variability and CT-based Leiden score in hypertension patients
Jianqiao Chen1, Xinqiang Ji2, Runtao Zhao2
1Department of Geriatrics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.
Insights
Increased systolic blood pressure variability in hypertensive patients is linked to more severe coronary atherosclerotic plaque. Monitoring blood pressure variability can help predict plaque severity and progression.
Area of Science:
- Cardiology
- Hypertension Research
- Vascular Biology
Background:
- Ambulatory blood pressure monitoring (ABPM) effectively predicts cerebrovascular events in hypertension.
- The relationship between blood pressure variability (BPV) and coronary atherosclerotic plaque severity is not well understood.
Purpose of the Study:
- To investigate the association between BPV and the severity of coronary atherosclerotic plaque in hypertensive patients.
Main Methods:
- 783 hypertensive patients with suspected coronary artery disease underwent ABPM and coronary computed tomographic angiography.
- Patients were stratified into low, medium, and high-risk groups based on the Leiden score.
- Pearson correlation and multivariate logistic regression analyses were employed.
Main Results:
- Higher mean systolic blood pressure (SBP), nighttime mean SBP, and SBP variability were observed in the high-risk group.
- 24-hour SBP variability was associated with low and medium-high risk Leiden scores.
- Smoking, diabetes, and 24-hour SBP variability were independently associated with medium-high risk Leiden scores.
Conclusions:
- Elevated SBP variability in hypertensive patients correlates with a higher Leiden score, indicating more severe coronary atherosclerotic plaque.
- Monitoring SBP variability is significant for predicting and preventing the progression of coronary atherosclerotic plaque.
Background:
Blood pressure variability (BPV) obtained from ambulatory blood pressure monitoring (ABPM) has been demonstrated to accurately predict the risk of cerebrovascular events and death in hypertension patients, however, the association between BPV and the severity of coronary atherosclerotic plaque remains unclear.
Methods:
Patients with hypertension combined with suspected coronary artery disease (CAD) were collected, who underwent both ABPM and coronary computed tomographic angiography (CCTA) from December 2017 to March 2022. Patients were divided into three groups according to the Leiden score: low-risk group (Leiden score <5), medium-risk group (Leiden score 5-20), and high-risk group (Leiden score >20). The clinical characteristics of patients were collected and analyzed. Univariate Pearson correlation and multivariate Logistics regression were used to determine the association between BPV and the severity of coronary atherosclerotic plaque.
Results:
A total of 783 patients were included, with the average age of (62.85 ± 10.17) years and 523 males. Patients in the high-risk group had higher mean systolic blood pressure (SBP), nighttime mean SBP and SBP variability (P < 0.05). Leiden score with low risk was associated with 24 h-SBP variability (r = 0.35, P = 0.006) and 24 h-diastolic blood pressure (DBP) loading (r = -0.18, P = 0.027). Leiden score with medium and high risk was associated with nighttime mean SBP (r = 0.23, P = 0.005), 24 h-SBP variability (r = 0.32, P = 0.003), and the decrease of nighttime SBP (r = 0.24, P = 0.019). Multivariate Logistic analysis showed that smoking [odds ratio (OR) = 1.014, 95% confidential interval (CI): 1.0-1.07, P = 0.03], diabetes (OR = 1.43, 95% CI: 1.10-2.26, P = 0.01) and 24 h-SBP variability (OR = 1.35, 95% CI: 1.01-2.46, P = 0.01) were independently associated with Leiden score with medium and high risk.
Conclusion:
Larger SBP variability in hypertensive patients indicates the higher Leiden score and consequently the more serious coronary atherosclerotic plaque. Monitoring SBP variability has certain significance for predicting the severity of coronary atherosclerotic plaque and preventing its progression.
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