Relationships between 24-h blood pressure variability and 24-h central arterial pressure, pulse wave velocity and augmentation index in hypertensive patients

Abstract

Twenty-four-h blood pressure variability (BPV) predicts cardiovascular complications in hypertension, but its association with pulse wave indices (central arterial pressure, pulse wave velocity (PWV) and augmentation index (AIx)) is poorly understood. In the present study, we assessed the degree of the effect of 24-h BPV on 24-h pulse wave indices. Brachial blood pressure was measured non-invasively over the 24 h with an electronic, oscillometric, automated device (BPLab) in 661 uncomplicated treated or untreated hypertensive patients. Digitalized oscillometric waveforms were analyzed with a validated algorithm to obtain pulse wave indices. Twenty-four-h BPV was calculated as the unweighted (SDu) or weighted s.d. (SDw) of the mean blood pressure or as the average real variability (ARV). Twenty-four-h systolic BPV showed a direct and significant relationship with the central arterial systolic pressure (r=0.28 SDu, r=0.40 SDw, r=0.34 ARV), PWV (r=0.10 SDu, r=0.21 SDw, r=0.19 ARV) and AIx (r=0.17 SDu, r=0.27 SDw, r=0.23 ARV). After adjustment for age, sex, body mass index, antihypertensive treatment and 24-h systolic blood pressure, the relationship lost some power but was still significant for all measures, except for the AIx. Pulse wave indices were higher in patients with high BPV than in those with low BPV: after adjustment, these differences were abolished for the AIx. The diastolic BPV showed a weak association with the pulse wave indices. In conclusion, in hypertensive patients, 24-h systolic BPV is moderately and independently associated with 24-h central arterial pressure and stiffness.

Risk factors of the progression to hypertension and characteristics of natural history during progression: A national cohort study

“…There were two factors that showed a positive relation with progression in females: pulse pressure and fasting glucose. Although these factors are known to increase progressively with age [29,30], this result is important since adjustments were made to account for the timedependent age effect. Although this difference has not been previously discussed, it indicates that females may be more vulnerable to fasting glucose level or pulse pressure.…”

Blood pressure variability with different measurement methods

“…[8] Sustained BPV could also reflect alterations in regulatory mechanisms such as impaired sympathetic drive and baroreflex function (mainly correlated to increased arterial stiffness). [9,10]…”

Analysis of Vascular Aging in Arterial Hypertension — Population-based Study: Preliminary Results

“…Our study was able to evidence a greater prevalence of arterial stiffness among hypertensive individuals, demonstrating a statistically significant association among them. Consonant to the literature in which AH and high blood pressure rates are associated to vascular aging, thus it is possible to infer that PWV is an important predictive factor of AH morbidity and mortality [23,24,[31][32][33][34]. One of the possible biological explanation for the association between AH and PWV would be the BP causing an increase in AS and consequent increase in PWV, causing an increase to the blood pressure [10,12,16].…”