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Clinical Trial
. 2014 May 16;9(5):e97760.
doi: 10.1371/journal.pone.0097760. eCollection 2014.

The association between within-visit blood pressure variability and carotid artery atherosclerosis in general population

Yan Li  1 , Jing Liu  1 , Wei Wang  1 , Dong Zhao  1
Affiliations
Clinical Trial

The association between within-visit blood pressure variability and carotid artery atherosclerosis in general population

Yan Li et al. PLoS One. .

Abstract

Objectives: To determine whether within-visit blood pressure (BP) variability based on three measurements over minutes is associated with increased carotid intima-media thickness (IMT) and plaque in a general population.

Methods: A cross-sectional survey was performed in 2007, and a total of 1222 Beijing community residents aged 50-79 years belonging to part of the Chinese Multi-Provincial Cohort Study (CMCS) were recruited in this study. BP was measured three times at 5-minute intervals during a single visit, and the maximum absolute difference (MAD) between any two readings of three measurements was used to indicate within-visit BP variability. Carotid IMT and plaque scanned by B-mode ultrasound were identified as the surrogate end points in the intermediate stage of atherosclerosis.

Results: After adjustment for established cardiovascular risk factors, the odds ratio (OR) (95% confidence interval (CI)) for increased carotid IMT and internal carotid plaque associated with the highest within-visit diastolic BP (DBP) variability (MAD > mean + standard deviation (SD)) compared with participants in the lowest within-visit DBP variability (MAD ≤ mean -SD) was 4.92 (1.48-16.42) and 6.07 (1.31-28.10), respectively, in the normotensives (P = 0.01; P = 0.02). The OR (95% CI) for internal carotid plaque associated with the highest within-visit systolic BP (SBP) variability (MAD >mean +SD) compared with participants in the lowest within-visit SBP variability (MAD ≤ mean -SD) was 3.54 (1.26-10.00) in the hypertensives on antihypertensive therapy (P = 0.02).

Conclusions: Within-visit DBP variability was associated with increased carotid IMT and internal carotid plaque in the normotensive population, and within-visit SBP variability was associated with internal carotid plaque in hypertensive patients undergoing antihypertensive therapy.

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Conflict of interest statement

Competing Interests: All authors declare that none has any professional or personal competing interests to Pfizer. These competing interests include, but are not limited to, any relevance to employment, consultancy, patents, products in development, or marketed products that might influence the reporting of this paper. This therefore does not alter the authors' adherence to PLoS One policies on sharing data and materials.

Figures

Figure 1
Figure 1. Prevalence of carotid increased IMT and plaque stratified by within-visit maximum absolute difference of systolic blood pressure overall.
Figure 2
Figure 2. Prevalence of carotid increased IMT and plaque stratified by within-visit maximum absolute difference of diastolic blood pressure in normotensive subjects.
Figure 3
Figure 3. Prevalence of carotid increased IMT and plaque stratified by within-visit maximum absolute difference of systolic blood pressure in hypertensive patients.
See this image and copyright information in PMC

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