Visit-to-visit blood pressure variability is a marker of cardiac diastolic function and carotid atherosclerosis

BACKGROUND The associations between visit-to-visit blood pressure (BP) variability and cardiac function and carotid atherosclerosis is not clear. METHODS Study subjects were 144 subjects (80 were female, aged 73 ± 9 years) who underwent echocardiography and cervical ultrasonography. The ratio of early ventricular filling velocity to early diastolic mitral annular velocity (E/e'), ejection fraction, left ventricular mass index (LVMI), and maximum intima-media thickness (max-IMT) of the carotid artery were compared between the highest (high variability) and lowest (low variability) tertiles of the standard deviation of systolic BP (9.9 ± 3.5 mmHg). RESULTS E/e' and max-IMT were significantly greater in the high variability group than in the low variability group after adjusting for age, sex, baseline systolic BP, and other covariates (high variability vs. low variability; E/e': 13.03 ± 5.33 vs. 10.66 ± 3.30, multivariate-adjusted difference (β) = 1.82, 95% confidence interval 0.06-3.58; max-IMT: 1.65 ± 0.43 mm vs. 1.42 ± 0.46 mm, β = 0.20 mm, 95% confidence interval 0.03-0.36 mm). There were no significant differences in LVMI or ejection fraction. CONCLUSION These results indicate that high visit-to-visit BP variability is associated with diastolic function and carotid atherosclerosis, and is a possible risk factor for diastolic dysfunction and atherosclerosis.