Relation of blood pressure variability to carotid atherosclerosis and carotid artery and left ventricular hypertrophy

The relationship of blood pressure (BP) variability to cardiovascular targe t-organ damage is controversial. Studies examining BP variability and left ventricular (LV) hypertrophy have been contradictory, and only limited data on the relation of BP variability to carotid atherosclerosis and carotid a rtery hypertrophy exist. BP variability was assessed as the standard deviat ion and coefficient of variation of awake and asleep pressures in 511 normo tensive or untreated hypertensive subjects who underwent ambulatory BP moni toring and cardiac and carotid ultrasonography. Although the presence of fo cal carotid plaque was associated with an increase in ambulatory pressures and pressure variability, the differences in variability were eliminated by adjustment for age and absolute pressures. Similarly, LV mass was signific antly related to BP variability, but the significance of this finding was e liminated after adjustment for important covariates. In multivariate analys es, age was the primary determinant of carotid artery cross-sectional area, with a weak but independent contribution from awake systolic and diastolic BP variability in addition to absolute pressure. BP variability was not in dependently related to either carotid or LV relative wall thickness, both m easures of concentric remodeling. In the present study, awake BP variabilit y was weakly but independently associated with carotid artery cross-section al area, a measure of arterial hypertrophy. However, neither systolic nor d iastolic BP variability was independently associated with carotid atheroscl erotic plaque or LV mass.