Key result
The highest tertile of visit-to-visit systolic blood pressure variability was associated with arterial stiffness progression compared to the lowest tertile (OR 1.64; 95% CI 1.11-2.43).
Why the study?
Studies evaluating the mutual relationship between blood pressure variability and arterial stiffness using time-dependent changes in arterial stiffness are scarce.
Is there a bidirectional association between visit-to-visit systolic blood pressure variability and arterial stiffness progression in patients with chronic kidney disease?
Cohort (n=1,036)
Is there a bidirectional association between visit-to-visit systolic blood pressure variability and arterial stiffness progression in patients with chronic kidney disease?
There is a significant bidirectional relationship between visit-to-visit systolic blood pressure variability and arterial stiffness progression in patients with chronic kidney disease.
Hypothesis-generating for bidirectional SBP variability–stiffness link in CKD; prospective trials needed to assess causality.
OBJECTIVE: Studies on the mutual relationship between blood pressure (BP) variability and arterial stiffness using time-dependent changes in arterial stiffness are scarce. METHODS: In this prospective cohort of Korean patients with chronic kidney disease (CKD) G1-G5 without kidney replacement therapy, we studied the bidirectional association between visit-to-visit SBP variability (VVSV) and arterial stiffness in 1036 participants who underwent brachial-ankle pulse wave velocity (baPWV) measurement at baseline and year four. We constructed multivariable logistic regression models using two analytical sets. First, we determined the VVSV [standard deviation (SD)] of all SBP readings over 4 years, and then calculated the odds ratios (ORs) for arterial stiffness progression according to tertiles of VVSV. Arterial stiffness progression was defined as at least 75th percentile of the difference in baPWV between baseline and year four. Second, we analysed the ORs for at least 75th percentile of the 4-year VVSV according to tertiles of baseline baPWV. RESULTS: Compared with the lowest tertile of VVSV (SD), the ORs [95% confidence interval (95% CI)] for arterial stiffness progression were 1.42 (0.96-2.10) and 1.64 (1.11-2.43) for the middle and highest tertiles, respectively. In the second analysis based on tertiles of baseline baPWV, the ORs for at least 75th percentile of VVSV (SD) were 1.41 (95% CI, 0.95-2.10) and 1.64 (95% CI, 1.04-2.61) for the middle and highest tertiles, respectively. This association was similar in both analytical models when VVSV and baPWV were treated as continuous variables. CONCLUSION: There is a bidirectional relationship between BP variability and arterial stiffness in patients with CKD.
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Park et al. (2022) conducted a cohort in chronic kidney disease (CKD) (n=1,036). Visit-to-visit SBP variability (VVSV) vs. Lowest tertile of VVSV was evaluated on Arterial stiffness progression (at least 75th percentile of the difference in baPWV between baseline and year four) (OR 1.64, 95% CI 1.11-2.43). The highest tertile of visit-to-visit systolic blood pressure variability was associated with arterial stiffness progression compared to the lowest tertile (OR 1.64; 95% CI 1.11-2.43).
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