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Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population.

ABSTRACT: Whether elevated beat-to-beat blood pressure variability (BPV) has an influence on vascular elasticity is confounded and poorly understood. This study hypothesized that the increased BPV could have an adverse effect on the vascular elasticity, as estimated by total arterial compliance (TAC), independent of blood pressure (BP) values. Beat-to-beat BP and TAC were measured in 81 hypertensive patients (experimental population) and in 80 normal adults (control population). Beat-to-beat BPV was assessed by standard deviation (SD), average real variability (ARV), residual standard deviation (RSD) and variation independent of mean (VIM). In experimental population, systolic BPV (SBPV) showed a significant correlation with TAC (SD, r?=?-0.326, p?

SUBMITTER: Xia Y

PROVIDER: S-EPMC5566212 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population.

Xia Yufa Y Liu Xin X Wu Dan D Xiong Huahua H Ren Lijie L Xu Lin L Wu Wanqing W Zhang Heye H

Scientific reports 20170821 1

Whether elevated beat-to-beat blood pressure variability (BPV) has an influence on vascular elasticity is confounded and poorly understood. This study hypothesized that the increased BPV could have an adverse effect on the vascular elasticity, as estimated by total arterial compliance (TAC), independent of blood pressure (BP) values. Beat-to-beat BP and TAC were measured in 81 hypertensive patients (experimental population) and in 80 normal adults (control population). Beat-to-beat BPV was asses ...[more]

PMID: 28827561

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Project description:Background Beat-to-beat blood pressure variability (BPV) is associated with an increased risk of stroke but can be driven by both healthy physiological processes and failure of compensatory mechanisms. Blood pressure (BP) complexity measures structured, organized variations in BP, as opposed to random fluctuations, and its reduction may therefore identify pathological beat-to-beat BPV. Methods and Results In the prospective, population-based OXVASC (Oxford Vascular Study) Phenotyped Cohort with transient ischemic attack or minor stroke, patients underwent at least 5 minutes of noninvasive beat-to-beat monitoring of BP (Finometer) and ECG to derive the following: BPV (coefficient of variation) and complexity (modified multiscale entropy) of systolic BP and diastolic BP, heart rate variability (SD of R-R intervals), and baroreflex sensitivity (BRS; Welch's method), in low- (0.04-0.15 Hz) and high-frequency (0.15-0.4 Hz) bands. Associations between BPV or BP complexity with autonomic indexes and arterial stiffness were determined (linear regression), unadjusted, and adjusted for age, sex, and cardiovascular risk factors. In 908 consecutive, consenting patients, BP complexity was inversely correlated with BPV coefficient of variation (P<0.001) and was similarly reduced in patients with hypertension or diabetes (P<0.001). However, although BPV coefficient of variation had a U-shaped relationship with age, BP complexity fell systematically across age quintiles (quintile 1: 15.1 [14.0-16.1] versus quintile 5: 13.8 [12.4-15.1]) and was correlated with markers of autonomic dysfunction (heart rate variability SD of R-R intervals: r = 0.20; BRS low frequency: 0.19; BRS high frequency: 0.26) and arterial stiffness (pulse wave velocity: -0.21; all P<0.001), even after adjustment for clinical variables (heart rate variability SD of R-R intervals: 0.12; BRS low frequency and BRS high frequency: 0.13 and 0.17; and pulse wave velocity: -0.07; all P<0.05). Conclusions Loss of BP complexity discriminates BPV because of pathological failure of compensatory mechanisms and may represent a less confounded and potentially modifiable risk factor for stroke.

Dataset Information

Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population.

Publications

Influence of beat-to-beat blood pressure variability on vascular elasticity in hypertensive population.

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