Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study

In a cross-sectional study, visit-to-visit blood pressure (bp) variability was shown to be associated with artery remodelling. here, we investigated the impact of visit-to-visit bp variability and average bp on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. bp measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit bp variability expressed as the standard deviation (s.d.), coefficient of variation (cv), maximum bp, minimum bp and delta (maximum−minimum) bp. we measured mean intima-media thickness (imt) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. in a multiple regression analysis, the maximum, minimum, s.d. and average of systolic bp (sbp) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. there were no significant associations between the visit-to-visit bp variability measures and the change in mean imt. significant associations of maximum, minimum, s.d. and average sbp were found with increased β-values in the subjects without calcium channel blocker (ccb) use and in the subjects using renin–angiotensin system inhibitors (rasis). thus, exaggerated visit-to-visit sbp variability and a high average sbp level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without ccbs use and in those using a rasi.