Relation between blood pressure variability and carotid artery damage in hypertension: Baseline data from the European Lacidipine Study on Atherosclerosis (ELSA)

Giuseppe Mancia, Gianfranco Parati, Michael Hennig, Birgit Flatau, Stefano Omboni, Fabio Glavina, Bruno Costa, Renate Scherz, Gene Bond, Alberto Zanchetti

Research output: Contribution to journalArticle

Abstract

Background: Baseline data from the European Lacidipine Study on Atherosclerosis (ELSA) have shown that carotid intima-media thickness (IMT) is not related to diastolic blood pressure (BP), but that it is related to clinic systolic (S) or pulse pressure (PP) and more so to their 24 h average values. The aim of the present study was to determine whether IMT independently relates to additional information obtained through ambulatory BP, in particular to SBP or PP variability. Methods and results: In 1663 hypertensive patients, after a wash-out period from antihypertensive treatment (mean age 56.2 ± 7.65 years), IMT was assessed from 12 different carotid sites. Ambulatory BP measurements were performed every 15 min (day) and every 20 min (night). IMT values were positively related to 24 h, day and night average SBP and PP. There was some relationship of IMT with day-night or clinic-day SBP and PP differences. The most important finding, however, was that IMT values were related with 24 h SBP or PP standard deviation (P <0.001), a measure of overall SBP or PP variability. The relationship was seen also by multiple regression analysis, the standard deviation for SBP or PP only following age and 24 h average SBP or PP in accounting for IMT values. Conclusions: This is the first demonstration from a large database that not only average 24 h PP and SBP values, but also 24 h BP fluctuations, are associated with, and possibly determinants of, the alterations of large artery structure in hypertension.

Original languageEnglish
Pages (from-to)1981-1989
Number of pages9
JournalJournal of Hypertension
Volume19
Issue number11
DOIs
Publication statusPublished - 2001

Keywords

  • Atherosclerosis
  • Blood pressure variability
  • Hypertension
  • Pulse pressure
  • Systolic blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology

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