Is diurnal systolic blood pressure variability associated with early carotid atherosclerosis in patients older than 55 years?
Diurnal systolic blood pressure variability is a strong predictor of early carotid atherosclerosis, independent of absolute blood pressure levels.
We studied the relationship between circadian blood pressure changes and development of early carotid atherosclerosis in 208 hypertensive and 216 normotensive patients older than age 55 years. Blood pressure patterns were evaluated noninvasively with a long-term blood pressure monitor, and extent of atherosclerosis was measured as the intima to media wall thickness (IMT) of the common carotid artery. No significant differences regarding age, sex, smoking, diabetes, cholesterol, and triglycerides were found between both patient groups. The age-adjusted IMT was significantly larger in the hypertensive patients (1.34 mm 95% confidence interval 1.24, 1.44 versus 1.18 mm 1.14, 1.22; p 1.5 mm) increased with raised diurnal systolic blood pressure variability (> 15 mm Hg) in both groups (normotensive: 8.5 2.30; hypertensive: 12.6 4, 43). The diurnal systolic blood pressure variability is the strongest predictor of early carotid atherosclerosis measured with B-mode ultrasonography and is useful to define the risk-benefit ratio of therapeutic approaches, particularly in patients with only slightly elevated blood pressure levels.
Sander et al. (Thu,) studied this question.