Arterial Stiffness and Blood Pressure Fluctuactions in Subjects with Arterial Hypertension

Abstract

Background The aim of the study was to assess the relationship between stiffness of large arteries and fluctuations of arterial pressure during ambulatory blood pressure monitoring (ABPM) and postural tests.
Material and methods The study involved 42 patients (16 men and 26 women) aged 38 to 84 years, with essential hypertension. Pulse wave velocity (PWV), orthostatic test, tilt test and ABPM were performed in all patients. Subjects were divided according to the median of PWV (11.38 m/s).
Results Patients with more rigid arteries (PWV 14.45 ± 2.57 vs 9.58 ± 1.66 m/s) were older (59.57 ± 12.99 vs 73.90 ± 6.78 years, p < 0.001), but mean systolic and diastolic pressures in ABPM were similar in both groups ( 138.3 ± 10.2/83.3 ± 7.4 vs 142.4 ± 12.1/78.6 ± 9.4 mm Hg). Variability of systolic pressure (SBP) was greater in subjects with stiffer arteries (mean SD 12.8 ± 2.8 vs 16.7 ± 3.6 mm Hg, p < 0.001). Changes of blood pressure and heart rate during orthostatic and tilt tests were similar in both groups. Direct associations between age and variability of SBP during 24 hours, day and night were found (r = 0.4; 0.55; 0,33 respectively). Moreover variability of SBP was related to PWV (r = 0.36; 0.52; 0.29 respectively). Variability of diastolic blood pressure during night was influenced by age (r = 0.33) and PWV (r = 0.29), and during day only by age (r = 0.43).
Conclusions 1. Advanced age is a strong determinant of arterial stiffness in hypertension. 2. Blood pressure variability is related both to age and stiffness of the large arteries.