Beat-to-beat and day-to-day home systolic blood pressure variability were significantly associated with physiological measures like aortic stiffness (OR 1.84, P<0.0001) and response to arithmetic.
Observational (n=223)
Beat-to-beat and day-to-day systolic blood pressure variability share common physiological correlates such as aortic stiffness and autonomic reactivity, identifying potential therapeutic targets for stroke risk reduction.
Odds Ratio: 1.64
p-value: p=<0.0001
BACKGROUND AND PURPOSE: Visit-to-visit and day-to-day variability in systolic blood pressure (SBP) are associated with an increased risk of stroke, more strongly than variability on 24-hour ambulatory BP monitoring, but underlying physiological mechanisms are unclear. We related potentially relevant physiological characteristics to beat-to-beat, ambulatory, and day-to-day BP variability to identify underlying mechanisms and potential therapeutic targets. METHODS: BP variability (coefficient of variation CV) on 1-month home BP monitoring (3 sitting readings, 3× daily), on 24-hour ambulatory BP monitoring, and on 5-minute beat-to-beat monitoring was related to BP reactivity (to mental arithmetic), arterial aging (aortic stiffness: carotid-femoral pulse wave velocity; aortic pulsatility), heart rate variability (CV of normal-to-normal R-R interval), and orthostatic responses. RESULTS: In 223 patients within 6 weeks of a transient ischemic attack or minor stroke, beat-to-beat and home SBP-CVs were associated with response to arithmetic (beat-to-beat odds ratio per SD=1.64; P<0.0001 and home BP monitoring, 1.41; P=0.025), aortic stiffness (1.84; P<0.0001 and 1.31; P=0.04), aortic pulsatility (1.98; P<0.0001 and 1.61; P<0.0001), and heart rate variability-CV of normal-to-normal R-R interval (1.34; P=0.03 and 1.35; P=0.03), independently of age, sex, and aortic BP. Orthostatic BP changes were associated only with SBP-CV on home BP monitoring (0.62; P=0.002). In contrast, no physiological measures were associated with within-day BP variability on awake ambulatory BP monitoring except response to mental arithmetic (1.40; P=0.01). CONCLUSIONS: Beat-to-beat and day-to-day SBP variability, but not variability on ambulatory BP monitoring, had similar physiological correlates, suggesting common underlying mechanisms and identifying potentially treatable targets that may be responsible for the relationship between SBP variability and stroke risk.
Webb et al. (Fri,) conducted a observational in Transient ischemic attack or minor stroke (n=223). Systolic blood pressure variability was evaluated on Association with physiological characteristics (response to arithmetic, aortic stiffness, aortic pulsatility, heart rate variability) (OR 1.64, p=<0.0001). Beat-to-beat and day-to-day home systolic blood pressure variability were significantly associated with physiological measures like aortic stiffness (OR 1.84, P<0.0001) and response to arithmetic.
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