Short-term beat-to-beat but not ambulatory blood pressure variability is correlated to carotid intima-media thickness

Michas, F.; Stamatelopoulos, Kimon; Barlas, Gerassimos; Koroboki, Eleni; Tsouma, Iliana; Vemmos, Konstantinos

doi:10.1097/mbp.0000000000000062

Cited by 12 publications

(15 citation statements)

References 14 publications

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“…[30,31] A recent study reported that time rate of BP variation but not ambulatory BPV was correlated with carotid IMT. [32] These controversial results may have arisen from differences in patient population selection, BPV index, sample size, study endpoints, and other factors. In our previous study, [20] we found that, for the nondiabetes patients, SBP fluctuations during daytime and during a 24 hours period were significantly associated with increased CCA-IMT.…”

Section: Discussionmentioning

confidence: 99%

Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes

Chen

et al. 2016

Medicine

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Carotid intima-media thickness (IMT) has been one widely used index of early carotid atherosclerosis. We speculated that the influence of blood pressure variability (BPV) on early carotid atherosclerosis may be varied by the location of the carotid artery and diabetes history. Thus, the goal of this study was to evaluate the effects of BPV on early arteriosclerosis progression in different segments of the carotid artery for hypertension with and without diabetes.A total of 148 hypertension patients who underwent 24 hours ambulatory blood pressure (BP) monitoring and carotid ultrasonography were enrolled in this study. Of them, 84 subjects were without diabetes, and 64 subjects were with diabetes. Short-term BPV during daytime, nighttime, and over 24 hours were evaluated through standard deviation (SD) and average real variability (ARV). We measured carotid IMT at left and right common carotid artery (CCA), carotid bulb, and the origin of the internal carotid artery (ICA). The associations between segment-specific measurements of carotid IMT and 24 hours ambulatory BPV were analyzed.We found that IMT at the common carotid artery (CCA-IMT) and IMT at the internal carotid artery (ICA-IMT) were more closely associated with BPV than was carotid bulb IMT. In addition, for all subjects, BPV was clearly associated with left CCA-IMT but not with right CCA-IMT. Furthermore, in diabetes patients, nighttime systolic BPV was independently related to mean CCA-IMT (P < 0.01) and mean bulb IMT (P < 0.01). In contrast, in nondiabetes patients, daytime and 24 hours systolic BPV was positively associated with mean CCA-IMT (P < 0.05), but not independent after adjusting for baseline characteristics such as age and sex.The findings of our study indicate a segment-specific association between carotid IMT and 24 hours ambulatory BPV, and the associations also vary according to the diabetes history. We conclude that BPV plays a distinct role in early carotid arteriosclerosis progression within different segments of the carotid artery, especially for the hypertensions with and without diabetes.

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Section: Discussionmentioning

confidence: 99%

Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes

Chen

et al. 2016

Medicine

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“…Furthermore, Manios et al [31] corroborate the hypothesis that increased BP variability influences CIMT progression. Eighty-five patients were recruited (40 without hypertension and 45 with hypertension) with a mean age of 54.…”

Section: Discussionmentioning

confidence: 75%

Carotid intima–media thickness and incident hypertension: the Brazilian Longitudinal Study of Adult Health

Dutra,

Bensenor,

Goulart

et al. 2023

Journal of Hypertension

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Background: High blood pressure (BP) increases carotid intima–media thickness (CIMT). On the other hand, it is not clear whether the vascular abnormalities reflected in high CIMT may predict incident hypertension. The present study aims to investigate the association between CIMT and incident hypertension after 4 years of follow-up in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multiethnic sample of middle-aged adults from six Brazilian cities. Methods: We analyzed data from 6682 ELSA-Brasil participants (aged 35–74) without hypertension and with complete CIMT data at baseline. After 4 years of follow-up, we describe hypertension incidence, stratifying the sample according to age, sex, and race-specific CIMT quartiles. We also built crude and adjusted Poisson regression models to analyze the association between mean and maximal CIMT values and incident hypertension. Results: We found incident hypertension in 987 (14.8%) participants. According to mean CIMT quartile groups, hypertension incidence varied from 10.2% (first quartile group) to 22.4% (fourth quartile group; P for trend <0.001). In fully adjusted models, 0.1 mm increments in mean CIMT values were associated with a 16% [relative risk (RR):1.16; 95% confidence interval (95% CI) 1.10–1.21; P < 0.001] higher risk of incident hypertension, respectively. Results were similar when maximal CIMT values were considered instead of mean CIMT values. Conclusion: CIMT values at baseline strongly predicted incident hypertension after 4 years of follow-up in this large multiethnic cohort. This highlights the relationship between CIMT and BP and may provide important insights into the significance of this ultrasound measurement.

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“…Table 2 summarizes the characteristics of selected studies. Two of the 19 studies are longitudinal studies [ 40 , 42 ], 11 are case–control studies [ 20 , 35 , 37 , 39 , 43 , 44 , 46 – 48 , 50 , 51 ], while the remaining are cohort studies which only involve the hypertension group [ 34 , 36 , 38 , 41 , 45 , 49 ]. 15 studies involved participants with a mean age ranging from 40 to 65 years [ 20 , 34 – 37 , 39 – 44 , 46 , 48 – 50 ], while three studies recruited older individuals aged above 65 years [ 45 , 47 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

Non-invasive parameters of autonomic function using beat-to-beat cardiovascular variations and arterial stiffness in hypertensive individuals: a systematic review

Ooi,

Lim,

Seng

et al. 2024

BioMed Eng OnLine

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Purpose Non-invasive, beat-to-beat variations in physiological indices provide an opportunity for more accessible assessment of autonomic dysfunction. The potential association between the changes in these parameters and arterial stiffness in hypertension remains poorly understood. This systematic review aims to investigate the association between non-invasive indicators of autonomic function based on beat-to-beat cardiovascular signals with arterial stiffness in individuals with hypertension. Methods Four electronic databases were searched from inception to June 2022. Studies that investigated non-invasive parameters of arterial stiffness and autonomic function using beat-to-beat cardiovascular signals over a period of > 5min were included. Study quality was assessed using the STROBE criteria. Two authors screened the titles, abstracts, and full texts independently. Results Nineteen studies met the inclusion criteria. A comprehensive overview of experimental design for assessing autonomic function in terms of baroreflex sensitivity and beat-to-beat cardiovascular variabilities, as well as arterial stiffness, was presented. Alterations in non-invasive indicators of autonomic function, which included baroreflex sensitivity, beat-to-beat cardiovascular variabilities and hemodynamic changes in response to autonomic challenges, as well as arterial stiffness, were identified in individuals with hypertension. A mixed result was found in terms of the association between non-invasive quantitative autonomic indices and arterial stiffness in hypertensive individuals. Nine out of 12 studies which quantified baroreflex sensitivity revealed a significant association with arterial stiffness parameters. Three studies estimated beat-to-beat heart rate variability and only one study reported a significant relationship with arterial stiffness indices. Three out of five studies which studied beat-to-beat blood pressure variability showed a significant association with arterial structural changes. One study revealed that hemodynamic changes in response to autonomic challenges were significantly correlated with arterial stiffness parameters. Conclusions The current review demonstrated alteration in autonomic function, which encompasses both the sympathetic and parasympathetic modulation of sinus node function and vasomotor tone (derived from beat-to-beat cardiovascular signals) in hypertension, and a significant association between some of these parameters with arterial stiffness. By employing non-invasive measurements to monitor changes in autonomic function and arterial remodeling in individuals with hypertension, we would be able to enhance our ability to identify individuals at high risk of cardiovascular disease. Understanding the intricate relationships among these cardiovascular variability measures and arterial stiffness could contribute toward better individualized treatment for hypertension in the future. Systematic review registration: PROSPERO ID: CRD42022336703. Date of registration: 12/06/2022.

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Short-term beat-to-beat but not ambulatory blood pressure variability is correlated to carotid intima-media thickness

Abstract: Short-term beat-to-beat TR of BP variation is associated independently with CCA-IMT values and presents a better predictor of target organ damage involvement than BP variability indexes derived from ABPM.

Cited by 12 publications

References 14 publications

Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes

Influence of blood pressure variability on early carotid atherosclerosis in hypertension with and without diabetes

Carotid intima–media thickness and incident hypertension: the Brazilian Longitudinal Study of Adult Health

Non-invasive parameters of autonomic function using beat-to-beat cardiovascular variations and arterial stiffness in hypertensive individuals: a systematic review

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