Association among Systolic Blood Pressure Variation, Inflammation and Arterial Rigidity in Essential Hypertension

Introduction:

Although the association among arterial rigidity, inflammation and atherosclerosis has been established, that among systolic blood pressure variability (BPV, defined as blood pressure variation per unit time, inflammation and arterial rigidity is yet to be elucidated. The present study, which is the first to report simultaneous measurements of BPV (assessed by coefficient of variation (CV) in ambulatory blood pressure monitoring (ABPM)), inflammation (as reflected by levels of high-sensitivity C-reactive protein (hs-CRP) and arterial rigidity (assessed by brachial-ankle pulse wave velocity (ba-PWV) at baseline and 1-year follow-up, is aimed at testing the hypothesis that greater blood pressure variation (which is higher among hypertensive than normotensive individuals translates into stronger shearing force on the arterial wall, which could trigger inflammation (known to be involved in the pathogenesis and progression of hypertension  leading to arterial rigidity. The target of antihypertensive therapy therefore would not only be good blood pressure control and improved endothelial function but also BPV lowering with consequent decreased inflammation and greater arterial elasticity. The present study was conducted in Northeast China, where essential hypertension, which is associated with increased mortality, is common and daily salt intake is relatively high, approximately 16-18g, increasing susceptibility to atherosclerosis and more severe cardiovascular diseases.