reducing visit-to-visit variability in systolic blood pressure for improving the progression of carotid atherosclerosis and endothelial dysfunction in patients with hypertension management.

visit-to-visit variability (vvv) in blood pressure (bp) creates challenges to hypertension control and was independent associated with increased all-cause mortality in hypertensive patients. the major goal of the present study was to investigate the association of vvv in systolic (s)bp with progression of carotid atherosclerosis and en-dothelial dysfunction in on-treated hypertensive patients.overall, 356 hypertensive patients were enrolled and completed the trial. clinic bp was measured at baseline and at 3 monthly thereafter. carotid artery ultrasound and endothelial function were evaluated at baseline and annually follow-up visit. vvv in bp was assessed by standard deviation (sd) and coefficient of variation (cv) of serial follow-up bp measurements. the patients were divided into low, middle, and high group by tertile of sd in sbp.decrease percentage of maximum intima-media thickness (imt) and stiffness index β and increase percentage of brachial flow-mediated dilation (fmd) and nitric oxide (no) in lower groups were significant greater than in higher groups (p < 0.05). change percentage of stiffness index β and endothelin-1 positively, and change percentage of fmd and no negatively correlated with sd, cv, maximum, and delta of sbp (p < 0.05). sd and cv of sbp were risk factors for change percentage of imt, stiffness index β, fmd, no, and endothelin-1 independently of other influential factors, such as age, and mean sbp.excessive vvv in sbp maybe increase carotid atherosclerosis and impair endothelial function in on-treated hypertensive patients. reducing vvv in sbp is benefit for patients with hypertension management.