Increased systolic blood pressure variability in elderly hypertensive patients is associated with atherosclerotic lesions and impaired hemodynamics in the carotid arteries.
Hypothesis-generating link between daytime SBP variability and carotid atherosclerosis in elderly hypertensives; prospective studies needed to clarify causality and implications.
To compare blood pressure (BP) variability and the basic parameters of hemodynamics, the extent of an atherosclerotic process in the carotid arteries in patients aged 65 years or more who had uncomplicated systolic-and-diastolic and isolated systolic arterial hypertension (AH), 201 patients aged 65-88 years who had (mean AH duration, 12 44±0 64 years) was examined A rise was found in systolic and diastolic BP variability irrespective of the mode of BP elevation There was a predominance of external and common carotid arterial stenosis in hypertensives as compared with control normotensives (χ 2 =8,10,p 2 =5,2,p<0,05, respectively), impaired carotid hemodynamics described by the labored perfusion pattern (increased vascular resistance indices with decreased linear blood flow velocities) in the presence of lower arterial elastic and tonic properties A positive correlation was observed between the number of affected arteries and systolic BP variability during day-light hours (r=0,26,p<0,05) In addition, the latter had a negative correlation with linear blood flow velocities in the common carotids during the whole day and day-light hours (r=-0,33-0,34,p<0,01 and r=-0,25-0,26,p<0,05, respectively) The increased systolic BP variability is due to atherosclerotic lesions of mainly the common carotid arteries with altered baroreflex sensitivity
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Nosov et al. (2005) studied this question.
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