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Comparative Study
. 2013 Jul;26(7):896-902.
doi: 10.1093/ajh/hpt040. Epub 2013 Mar 28.

Associations of aortic distensibility and arterial elasticity with long-term visit-to-visit blood pressure variability: the Multi-Ethnic Study of Atherosclerosis (MESA)

Daichi Shimbo  1 , Steven Shea, Robyn L McClelland, Anthony J Viera, Devin Mann, Jonathan Newman, Joao Lima, Joseph F Polak, Bruce M Psaty, Paul Muntner
Affiliations
Comparative Study

Associations of aortic distensibility and arterial elasticity with long-term visit-to-visit blood pressure variability: the Multi-Ethnic Study of Atherosclerosis (MESA)

Daichi Shimbo et al. Am J Hypertens. 2013 Jul.

Abstract

Background: Although higher visit-to-visit variability (VVV) of blood pressure (BP) is associated with increased cardiovascular disease risk, the physiological basis for VVV of BP is incompletely understood.

Methods: We examined the associations of aortic distensibility (assessed by magnetic resonance imaging) and artery elasticity indices (determined by radial artery pulse contour analysis) with VVV of BP in 2,640 and 4,560 participants, respectively, from the Multi-Ethnic Study of Atherosclerosis. Arterial measures were obtained at exam 1. BP readings were taken at exam 1 and at 3 follow-up visits at 18-month intervals (exams 2, 3, and 4). VVV was defined as the SD about each participant's mean systolic BP (SBP) across visits.

Results: The mean SDs of SBP were inversely associated with aortic distensibility: 7.7, 9.9, 10.9, and 13.2mm Hg for quartiles 4, 3, 2, and 1 of aortic distensibility, respectively (P trend < 0.001). This association remained significant after adjustment for demographics, cardiovascular risk factors, mean SBP, and antihypertensive medication use (P trend < 0.01). In a fully adjusted model, lower quartiles of large artery and small artery elasticity (LAE and SAE) indices were also associated with higher mean SD of SBP (P trend = 0.02 for LAE; P trend < 0.001 for SAE).

Conclusions: In this multiethnic cohort, functional alterations of central and peripheral arteries were associated with greater long-term VVV of SBP.

Keywords: arteries; blood pressure; epidemiology; hypertension; vasculature..

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Figures

Figure 1.
Figure 1.
SD of systolic blood pressure (SBP) across exams 1–4 by quartile of aortic distensibility (top panel), large artery distensibility (LAE) index (middle panel), and small artery distensibility (SAE) index (bottom panel). Data are expressed as mean (bar) with 95% confidence intervals (line). For aortic distenstibility, LAE, and SAE, P trends are all < 0.001.
See this image and copyright information in PMC

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