Document Detail

Relationship between ambulatory blood pressure and aortic arch atherosclerosis.
MedLine Citation:
PMID:  22296886     Owner:  NLM     Status:  MEDLINE    
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.
Shinichi Iwata; Zhezhen Jin; Joseph E Schwartz; Shunichi Homma; Mitchell S V Elkind; Tatjana Rundek; Ralph L Sacco; Marco R Di Tullio
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-01-10
Journal Detail:
Title:  Atherosclerosis     Volume:  221     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-26     Completed Date:  2012-07-26     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  427-31     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Department of Medicine, Columbia University, New York, NY 10032, USA.
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MeSH Terms
Aged, 80 and over
Aorta, Thoracic / physiopathology*,  ultrasonography
Aortic Diseases / etiology,  physiopathology*,  ultrasonography
Atherosclerosis / etiology,  physiopathology*,  ultrasonography
Blood Pressure*
Blood Pressure Monitoring, Ambulatory*
Circadian Rhythm
Cross-Sectional Studies
Disease Progression
Logistic Models
Middle Aged
Multivariate Analysis
New York City
Odds Ratio
Predictive Value of Tests
Risk Assessment
Risk Factors
Severity of Illness Index
Stroke / etiology,  physiopathology
Grant Support

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