A7619 Association between long-term blood pressure variability and brachial-ankle pulse wave velocity progression in prehypertension patients over a 5 years follow-up

Abstract

Objectives: Studies suggested that higher systolic blood pressure (SBP) variability reduces bio-availability of nitric oxide and increases vascular smooth muscle cell proliferation. These vascular wall changes could stiffen the arterial wall. We investigated the association between long-term SBP variability and 5-year change in brachial-ankle pulse wave velocity among 204 prehypertension individuals. Methods: We enrolled 204 individuals with prehypertension at baseline and three follow-up visits in the study (mean age 67.5 ± 12.6 years, 45% males). At baseline physical examination, BP, laboratory data and ba-PWV were assessed. A ba-PWV follow-up examination was performed with a median time amounting to 5.25 ± 0.53 years. Within-individual standard deviation (SD), variability independent of the mean (VIM), and coefficient of variation (CV) of SBP across 3 visits were used to capture long-term SBP variability. Results: In a multivariate linear regression model, individuals in the 5th quintile as compared to those in the 1st quintile of SD, VIM, and CV of SBP had a 17.5% (95% CI: 15.8%, 19.3%), 15.8% (95% CI: 14.7%, 18.9%), and 16.9% (95% CI: 16.8%, 18.1%) higher progression in ba-PWV, respectively, after 5 years of follow-up. Conclusion: Linear trends in the progression of ba-PWV were observed across the quintiles of SBP variability indices. This finding suggest that higher long-term SBP variability may be a risk factor for arterial stiffness progression independent of mean BP in prehypertension subjects.