Assessment of Short‐term Blood Pressure Variability in Patients With Ascending Aortic Dilatation

Abstract

Background: Blood pressure variability (BPV) is a novel parameter related to adverse cardiovascular findings and events, especially in hypertensive patients. The aim of the present study was to investigate the relationship between short-term BPV and ascending aortic dilatation (AAD). Hypothesis: Hypertensive patients with AAD may exhibit higher short-term BPV compared to hypertensive patients with normal diameter ascending aorta and BPV may be correlated with aortic sizes. Methods: Seventy-six hypertensive patients with AAD and 181 hypertensive patients with a normal-diameter ascending aorta were retrospectively enrolled in the study. Clinical data, echocardiographic characteristics, and 24-hour ambulatory blood pressure monitoring characteristics were compared between the 2 groups. Standard deviation (SD) and of BP were used as parameters of BPV. Results: Although 24-hour mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similar between the 2 groups, the SD of SBP and SD of DBP values were significantly higher in AAD patients (17.2 ± 6.8 vs 13.8 ± 3.5, P < 0.01; and 12.1 ± 5.1 vs 10.7 ± 3.1, P = 0.02, respectively). Daytime SD of SBP values were higher in AAD patients, whereas nighttime SD of SBP values did not differ between groups. In multivariate linear regression analysis, 24-hour SD of SBP, 24-hour SBP, daytime SD of SBP, daytime SBP, and left ventricular mass index were independently correlated with aortic size index. Conclusions: Our study revealed higher levels of short-term BPV in hypertensive patients with AAD. This conclusion warrants further study.

Prognostic Impact of Blood Pressure Change Patterns on Patients With Aortic Dissection After Admission

“…In the current study, based on our multicenter data, we found that patients with a history of hypertension were more likely to have high SBPV, which was further associated with an increased incidence of AEs. These findings could be explained by the abnormal BP rhythm and poor BP control and were in line with the results of previous studies (17,19,33). There is a challenge, however, in estimating the average SBPV and classifying the patients into high and low SBPV groups given different target populations in clinical practice; additionally, when using only the SD of the SBP as a summary measure, there is a loss of information.…”

Proximal aorta dilatation in hypertension

“…The PAMELA study (Pressioni Arteriose Monitorate E Loro Associazioni) assessed home blood pressure monitoring (HBPM) and 24-h ambulatory blood pressure monitoring (ABPM) results in 1860 participants and concluded that BP was significantly correlated with ARD ( r = 0.35 for home SBP, r = 0.24 for 24-h SBP, P < 0.01 for both) [25]. Another two studies found that hypertensive patients with ascending aortic dilation had higher short-term blood pressure variability (BPV, assessed by standard deviation and coefficient of variation of BP) than those without dilation, indicating short-term BPV assessed by 24-h ABPM was a remarkable risk factor for aortic dilation in hypertensive patients [43,44]. Moreover, cumulative SBP load takes account of both magnitude and duration of exposure to elevated BP and has been confirmed as a promising predictor of cardiovascular risk [45].…”