Journal
JOURNAL OF HYPERTENSION
Volume 35, Issue 3, Pages 513-522Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0000000000001192
Keywords
aortic stiffness; blood pressure variability; pulse wave velocity; young adults
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Funding
- British Heart Foundation [FS/06/024, FS/11/65/28865]
- Commonwealth Scholarship and Fellowship Program
- Fukuda Denshi (Tokyo, Japan)
- National Institute for Health Research Oxford Biomedical Research Centre
- Oxford British Heart Foundation Centre for Research Excellence
- EPSRC [EP/G030693/1] Funding Source: UKRI
- MRC [G0400444] Funding Source: UKRI
- British Heart Foundation [FS/12/14/29354, FS/11/65/28865, FS/08/077/26366, RG/13/8/30266, PG/13/58/30397] Funding Source: researchfish
- Engineering and Physical Sciences Research Council [EP/G030693/1] Funding Source: researchfish
- Medical Research Council [G0400444] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10005] Funding Source: researchfish
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Introduction: Increased blood pressure (BP) variability is a cardiovascular risk marker for young individuals and may relate to the ability of their aorta to buffer cardiac output. We used a multimodality approach to determine relations between central and peripheral arterial stiffness and BP variability. Methods: We studied 152 adults (mean age of 31 years) who had BP variability measures based on SD of awake ambulatory BPs, 24-h weighted SD and average real variability (ARV). Global and regional aortic distensibility was measured by cardiovascular magnetic resonance, arterial stiffness by cardio-ankle vascular index (CAVI) and pulse wave velocity (PWV) by SphygmoCor (carotid-femoral) and Vicorder (brachial-femoral). Results: In young people, free from overt cardiovascular disease, all indices of SBP and DBP variability correlated with aortic distensibility (global aortic distensibility versus awake SBP SD: r = -0.39, P<0.001; SBP ARV: r = -0.34, P<0.001; weighted 24-h SBP SD: r = -0.42, P<0.001). CAVI, which closely associated with aortic distensibility, also related to DBP variability, as well as awake SBP SD (r = 0.19, P<0.05) and weighted 24-h SBP SD (r = 0.24, P<0.01), with a trend for SBP ARV (r = 0.17, P=0.06). In contrast, associations with PWV were only between carotid-femoral PWV and weighted SD of SBP (r = 0.20, P = 0.03) as well as weighted and ARV of DBP. Conclusion: Greater BP variability in young people relates to increases in central aortic stiffness, strategies to measure and protect aortic function from a young age may be important to reduce cardiovascular risk.
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