Τίτλος:
Time rate of blood pressure variation is associated with increased
common carotid artery intima-media thickness
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The extent of target-organ damage has been positively associated with
the magnitude of blood pressure ( BP) variability in essential
hypertension. However, the clinical implications of the rate of BP
changes have never been investigated. We evaluated the association
between the rate of systolic BP (SBP) variation derived from ambulatory
BP monitoring (ABPM) data analysis and the extent of common carotid
artery (CCA) intima-media thickness (IMT) in normotensive (n=280) and in
uncomplicated hypertensive subjects (n=234). The 24-hour rate of SBP
variation was significantly (P<0.001) higher in hypertensive (0.608 mm
Hg/min; 95% confidence interval [CI], 0.595 to 0.622) than in
normotensive individuals (0.567 mm Hg/min; 95% CI, 0.555 to 0.578),
even after adjusting for baseline characteristics, day-night BP changes,
24-hour heart rate (HR), SBP, and HR variability. In the entire group of
patients, multiple linear regression models revealed independent
determinants of CCA-IMT in the following rank order: age (P<0.001),
24-hour rate of SBP variation (P<0.001), male gender (P=0.004),
cholesterol (P=0.009), and smoking (P=0.014). A 0.1 mm Hg/min increase
in the 24-hour rate of SBP variation was associated to an increment of
0.029 mm (95% CI, 0.018 to 0.040) in CCA-IMT independent of BP and HR
levels, BP and HR variability, and dipping status. The rate of SBP
variation during the morning BP surge correlated independently (P<0.001)
to larger CCA-IMT values after adjustment for baseline characteristics
and other ABPM parameters. Thus, the rate of BP fluctuations is greater
in hypertensive patients and correlates to increased CCA-IMT. This
finding indicates that steeper BP variations may produce a greater
stress on the vessel wall and consequently result in medial hypertrophy
of the large arteries.
Συγγραφείς:
Zakopoulos, NA
Tsivgoulis, G
Barlas, G
Papamichael, C and
Spengos, K
Manios, E
Ikonomidis, I
Kotsis, V and
Spiliopoulou, I
Vemmos, K
Mavrikakis, M
Moulopoulos, SD
Περιοδικό:
JOURNAL OF HYPERTENSION
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
blood pressure; carotid arteries; blood pressure monitoring; baroreflex;
ultrasonography
DOI:
10.1161/01.HYP.0000158306.87582.43
