TY - JOUR
T1 - Relationship between ambulatory blood pressure and aortic arch atherosclerosis
AU - Iwata, Shinichi
AU - Jin, Zhezhen
AU - Schwartz, Joseph E.
AU - Homma, Shunichi
AU - Elkind, Mitchell S.V.
AU - Rundek, Tatjana
AU - Sacco, Ralph L.
AU - Di Tullio, Marco R.
N1 - Funding Information:
This study was supported by R01 NS36286 from the National Institute of Neurological Disorders and Stroke (NINDS) .
PY - 2012/4
Y1 - 2012/4
N2 - Objective: Atherosclerotic plaque in the aortic arch is an independent risk factor for ischemic stroke. Although high blood pressure (BP) measured at the doctor's office is known to be associated with aortic atherosclerosis, little is known on the association between 24-h ambulatory BP and aortic arch plaque presence and severity. Our objective was to clarify the association between ambulatory BP variables and aortic arch atherosclerosis in a community-based cohort. Methods: The study population consisted of 795 patients (mean age 71. ±. 9 years) participating in the Cardiovascular Abnormalities and Brain Lesions (CABL) study who underwent 24-h ambulatory BP monitoring (ABPM). Arch plaque was evaluated by 2D transthoracic echocardiography from a suprasternal window. Results: All systolic ABPM variables (24-h/daytime/nighttime mean systolic BP, daytime/nighttime systolic BP variability) were associated with the presence of any plaque and large (≥4. mm) plaque, whereas diastolic BP variables were not associated with aortic atherosclerosis. Multiple regression analysis indicated that nighttime systolic BP variability (expressed as the standard deviation of nighttime systolic BP) remained independently associated with large plaque after adjustment for age, sex, cigarette smoking, history of hypertension, diabetes mellitus, hypercholesterolemia, anti-hypertensive medication and nighttime mean systolic BP (odds ratio 1.39 per 1 standard deviation increase, 95% CI 1.00-1.93, P<. 0.05). Conclusion: Systolic ABPM variables are significantly associated with the presence of arch plaque. Nighttime systolic BP variability is independently associated with large arch plaque. These findings may have important implications in gaining further insights into the mechanism of arch plaque formation and progression.
AB - Objective: Atherosclerotic plaque in the aortic arch is an independent risk factor for ischemic stroke. Although high blood pressure (BP) measured at the doctor's office is known to be associated with aortic atherosclerosis, little is known on the association between 24-h ambulatory BP and aortic arch plaque presence and severity. Our objective was to clarify the association between ambulatory BP variables and aortic arch atherosclerosis in a community-based cohort. Methods: The study population consisted of 795 patients (mean age 71. ±. 9 years) participating in the Cardiovascular Abnormalities and Brain Lesions (CABL) study who underwent 24-h ambulatory BP monitoring (ABPM). Arch plaque was evaluated by 2D transthoracic echocardiography from a suprasternal window. Results: All systolic ABPM variables (24-h/daytime/nighttime mean systolic BP, daytime/nighttime systolic BP variability) were associated with the presence of any plaque and large (≥4. mm) plaque, whereas diastolic BP variables were not associated with aortic atherosclerosis. Multiple regression analysis indicated that nighttime systolic BP variability (expressed as the standard deviation of nighttime systolic BP) remained independently associated with large plaque after adjustment for age, sex, cigarette smoking, history of hypertension, diabetes mellitus, hypercholesterolemia, anti-hypertensive medication and nighttime mean systolic BP (odds ratio 1.39 per 1 standard deviation increase, 95% CI 1.00-1.93, P<. 0.05). Conclusion: Systolic ABPM variables are significantly associated with the presence of arch plaque. Nighttime systolic BP variability is independently associated with large arch plaque. These findings may have important implications in gaining further insights into the mechanism of arch plaque formation and progression.
KW - Ambulatory blood pressure
KW - Aortic arch atherosclerosis
KW - Blood pressure variability
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U2 - 10.1016/j.atherosclerosis.2012.01.010
DO - 10.1016/j.atherosclerosis.2012.01.010
M3 - Article
C2 - 22296886
AN - SCOPUS:84858703734
VL - 221
SP - 427
EP - 431
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 2
ER -