Associations of Aortic Distensibility and Arterial Elasticity With Long-Term Visit-to-Visit Blood Pressure Variability: The Multi-Ethnic Study of Atherosclerosis (MESA)

Shimbo, Daichi; Shea, Steven; McClelland, R.L.; Viera, Anthony J.; Mann, David; Newman, Jonathan; Lima, João A.C.; Polak, Joseph F.; Psaty, Bruce M.; Muntner, Paul

doi:10.1093/ajh/hpt040

Cited by 101 publications

(83 citation statements)

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“…3,13,20 Arterial stiffness and endothelial and smooth muscle dysfunction have been proposed as mechanisms underlying the association between VVV and outcome. 26,27 Furthermore, the underlying mechanisms accounting for the beneficial effect of CCBs-especially amlodipine-on VVV have not been clarified, but there are a few hypotheses. Zhang et al 28 investigated the effect of candesartan, indapamide, and amlodipine on BPV using ambulatory BP data before and after 3 months of treatment.…”

Section: Mechanisms Regarding Vvv and The Ccbsinduced Reduction In Vvvmentioning

confidence: 99%

Treating Visit-to-Visit Blood Pressure Variability to Improve Prognosis

et al. 2017

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Section: Mechanisms Regarding Vvv and The Ccbsinduced Reduction In Vvvmentioning

confidence: 99%

Treating Visit-to-Visit Blood Pressure Variability to Improve Prognosis

et al. 2017

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“…In this analysis, the association of SBP variability with renal end points persisted after adjustment for medication adherence. Alternatively, increased BP variability may reflect vascular dysfunction, such as increased arterial stiffness (30,31), endothelial dysfunction (32), or increased vascular inflammation (33). Similarly, autonomic dysfunction could lead to increased BP variability while increasing the risk of vascular events (34).…”

Section: 001mentioning

confidence: 99%

Visit-to-Visit Variability of BP and CKD Outcomes

Whittle

Lynch²,

Tanner³

et al. 2016

Clinical Journal of the American Society of Nephrology

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Background and objectives Increased visit-to-visit variability of BP is associated with cardiovascular disease risk. We examined the association of visit-to-visit variability of BP with renal outcomes among 21,245 participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.Design, setting, participants, & measurements We measured mean BP and visit-to-visit variability of BP, defined as SD, across five to seven visits occurring 6-28 months after participants were randomized to chlorthalidone, amlodipine, or lisinopril. The composite outcome included incident ESRD after assessment of SD of systolic BP or $50% decline in eGFR between 24 months and 48 or 72 months after randomization. We repeated the analyses using average real variability and peak value of systolic BP and for visit-to-visit variability of diastolic BP.Results Over a mean follow-up of 3.5 years, 297 outcomes occurred. After multivariable adjustment, including baseline eGFR and mean systolic BP, the hazard ratios for the composite end point were 1.29 (95% confidence interval [95% CI], 0.75 to 2.22), 1.76 (95% CI, 1.06 to 2.91), 1.46 (95% CI, 0.88 to 2.45), and 2.05 (95% CI, 1.25 to 3.36) for the second through fifth (SD of systolic BP =6. 63-8.82, 8.83-11.14, 11.15-14.56, and .14.56 mmHg, respectively) versus the first (SD of systolic BP ,6.63 mmHg) quintile of SD of systolic BP, respectively (P trend =0.004). The association was similar when ESRD and a 50% decline in eGFR were analyzed separately, for other measures of visit-to-visit variability of systolic BP, and for visit-to-visit variability of diastolic BP. ConclusionsHigher visit-to-visit variability of BP is associated with higher risk of renal outcomes independent of mean BP.

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“…It can therefore be assumed that visit-to-visit BPV is associated with atherosclerosis. 10 Endothelial dysfunction is considered to be the initial pathogenic event of atherosclerosis and is a risk factor for cardiovascular disease. 11,12 Keith et al 13 showed that higher visit-tovisit BPV was associated with endothelial dysfunction in African Americans, and suggested that endothelial dysfunction may be the link between visit-to-visit BPV and atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%