Ambulatory blood pressure, blood pressure variability and the prevalence of carotid artery alteration: The Ohasama study

Yoriko Shintani, Masahiro Kikuya, Azusa Hara, Takayoshi Ohkubo, Hirohito Metoki, Kei Asayama, Ryusuke Inoue, Taku Obara, Yoko Aono, Takanao Hashimoto, Junichiro Hashimoto, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Yutaka Imai

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Abstract

OBJECTIVES: To investigate the association between ambulatory blood pressure (BP) variables (level, short-term variability, circadian variation and morning pressor surge) and carotid artery alteration in a general population. METHODS: We measured ambulatory BP every 30 min in 775 participants (mean age 66.2 ± 6.2 years, 68.8% women) from the Japanese general population. Short-term BP variability during the daytime and night-time were estimated as within-subject standard deviation of daytime and night-time BP, respectively. Circadian BP variation was calculated as the percentage decline in nocturnal BP. Morning pressor surge was defined as morning BP minus pre-waking BP. The extent of carotid artery alteration was evaluated as the average of common carotid intima-media thickness (IMT) and the presence of focal carotid plaque. RESULTS: Daytime and night-time BP values were more closely associated with carotid artery alteration than casual BP. With mutual adjustment for daytime and night-time BP, the latter (P < 0.0001) was more closely associated with IMT, which represents diffuse arterial thickening and arteriosclerosis, than daytime BP (P = 0.2). Night-time systolic BP variability was positively associated with carotid plaque (focal atherosclerotic lesions) independently of possible confounding factors, including night-time systolic BP (P = 0.01). A diminished nocturnal decline in systolic BP was associated with a greater IMT after adjustment for confounding factors (P = 0.03). A morning pressor surge was not associated with carotid artery alteration. CONCLUSION: Ambulatory BP levels and BP variability were closely associated with carotid artery alteration, suggesting that these parameters are independent risk factors or predictors of carotid artery alteration.

Original languageEnglish
Pages (from-to)1704-1710
Number of pages7
JournalJournal of hypertension
Volume25
Issue number8
DOIs
Publication statusPublished - 2007 Aug 1

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Keywords

  • Ambulatory blood pressure
  • Blood pressure variability
  • Carotid atherosclerosis
  • General population
  • Night-time blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Shintani, Y., Kikuya, M., Hara, A., Ohkubo, T., Metoki, H., Asayama, K., Inoue, R., Obara, T., Aono, Y., Hashimoto, T., Hashimoto, J., Totsune, K., Hoshi, H., Satoh, H., & Imai, Y. (2007). Ambulatory blood pressure, blood pressure variability and the prevalence of carotid artery alteration: The Ohasama study. Journal of hypertension, 25(8), 1704-1710. https://doi.org/10.1097/HJH.0b013e328172dc2e