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Subjects with chronic spinal cord injury (SCI) exhibit increased subclinical atherosclerosis and worse left ventricular diastolic function in comparison to able-bodied individuals, independent of traditional cardiovascular risk factors [1][2][3][4]. SCI may impair the descending spinal sympathetic tract and promote alterations in blood pressure (BP) profile, such as loss of nocturnal dipping due to orthostatic hypotension, and labile hypertension secondary to uncontrolled sympathetic output as a consequence of autonomic dysreflexia [5]. These alterations, in turn, could potentially explain the increased cardiovascular risk attributed to chronic SCI [5,6]. This study evaluated the relationship between carotid and echocardiographic features and Ambulatory BP monitoring (ABPM) in SCI patients.Thirty-two nondiabetic, nonhypertensive, nonsmoker, normotensive and normolipemic men attended at a university hospital outpatient clinic with at least 1 year of SCI were evaluated. SCI level ranged from C4 to T12 and only individuals without any preserved motor function below the injury level were included. Fasting serum glucose, lipids and Creactive protein were measured using standard laboratory techniques. Office blood pressure was measured in the sitting position using validated digital oscillometric device (Omron HEM-705CP, Omron Corp.). ABPM was carried out using a Spacelabs 90207 device. Nocturnal dipping was defined as a reduction in the average systolic and diastolic BP at night greater than 10% compared to daytime values. Carotid ultrasonography and echocardiography studies were performed on each subject in the sitting position with a Vivid 3 Pro apparatus as previously described [2,3]. The study was approved by the Ethics Committee of the State University of Campinas and informed consent was obtained from all participants. The authors certify that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [7]. All values were expressed as mean± standard error and median (interquartile range). Univariate and linear regression analyses were used to evaluate the association between cardiovascular parameters and studied variables. A p-value b0.05 was considered significant.The features of enrolled subjects are shown in Table 1. No subject exhibited plaques at carotid ultrasound or presented complaints of autonomic dysreflexia or BP peaks at ABPM. ABPM values correlated with carotid IMT but not with cardiac parameters. In this regard, 24-h diastolic BP was the measurement showing major correlation with IMT (r =0.54; p =0.002) (Fig. 1). Conversely, office BP, nocturnal dipping status, clinical and laboratory variables exhibited no significant relationship with carotid or cardiac measurements. At last, linear regression analysis revealed that 24-h diastolic BP was the only variable independently associated with carotid IMT (β = 0.417 ± 0.193; p = 0.018) after adjustment for injury level (tetraplegia or paraplegia) and nocturnal dipping status.This report provided novel knowledge regard...

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