Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease

Rosalinde K E Poortvliet; Suzanne M Lloyd; Ian Ford; Naveed Sattar; Anton J M de Craen; Liselotte W Wijsman; Simon P Mooijaart; Rudi G J Westendorp; J Wouter Jukema; Wouter de Ruijter; Jacobijn Gussekloo; David J Stott

doi:10.1093/ajh/hpu181

Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease

Rosalinde K E Poortvliet, Suzanne M Lloyd, Ian Ford, Naveed Sattar, Anton J M de Craen, Liselotte W Wijsman, Simon P Mooijaart, Rudi G J Westendorp, J Wouter Jukema, Wouter de Ruijter, Jacobijn Gussekloo, David J Stott

7 Citations (Scopus)

Abstract

BACKGROUND: Visit-to-visit variability in blood pressure is an independent predictor of cardiovascular disease. This study investigates biological correlates of intra-individual variability in blood pressure in older persons.

METHODS: Nested observational study within the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) among 3,794 male and female participants (range 70-82 years) with a history of, or risk factors for cardiovascular disease. Individual visit-to-visit variability in systolic and diastolic blood pressure and pulse pressure (expressed as 1 SD in mm Hg) was assessed using nine measurements over 2 years. Correlates of higher visit-to-visit variability were examined at baseline, including markers of inflammation, endothelial function, renal function and glucose homeostasis.

RESULTS: Over the first 2 years, the mean intra-individual variability (1 SD) was 14.4mm Hg for systolic blood pressure, 7.7mm Hg for diastolic blood pressure, and 12.6mm Hg for pulse pressure. After multivariate adjustment a higher level of interleukin-6 at baseline was consistently associated with higher intra-individual variability of blood pressure, including systolic, diastolic, and pulse pressure. Markers of endothelial function (Von Willebrand factor, tissue plasminogen activator), renal function (glomerular filtration rate) and glucose homeostasis (blood glucose, homeostatic model assessment index) were not or to a minor extent associated with blood pressure variability.

CONCLUSION: In an elderly population at risk of cardiovascular disease, inflammation (as evidenced by higher levels of interleukin-6) is associated with higher intra-individual variability in systolic, diastolic, and pulse pressure.

Original language	English
Journal	American Journal of Hypertension
Volume	28
Issue number	4
Pages (from-to)	469-479
Number of pages	11
ISSN	0895-7061
DOIs	https://doi.org/10.1093/ajh/hpu181
Publication status	Published - 1 Apr 2015
Externally published	Yes

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10.1093/ajh/hpu181

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Poortvliet, R. K. E., Lloyd, S. M., Ford, I., Sattar, N., de Craen, A. J. M., Wijsman, L. W., Mooijaart, S. P., Westendorp, R. G. J., Jukema, J. W., de Ruijter, W., Gussekloo, J., & Stott, D. J. (2015). Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease. American Journal of Hypertension, 28(4), 469-479. https://doi.org/10.1093/ajh/hpu181

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title = "Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease",

abstract = "BACKGROUND: Visit-to-visit variability in blood pressure is an independent predictor of cardiovascular disease. This study investigates biological correlates of intra-individual variability in blood pressure in older persons.METHODS: Nested observational study within the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) among 3,794 male and female participants (range 70-82 years) with a history of, or risk factors for cardiovascular disease. Individual visit-to-visit variability in systolic and diastolic blood pressure and pulse pressure (expressed as 1 SD in mm Hg) was assessed using nine measurements over 2 years. Correlates of higher visit-to-visit variability were examined at baseline, including markers of inflammation, endothelial function, renal function and glucose homeostasis.RESULTS: Over the first 2 years, the mean intra-individual variability (1 SD) was 14.4mm Hg for systolic blood pressure, 7.7mm Hg for diastolic blood pressure, and 12.6mm Hg for pulse pressure. After multivariate adjustment a higher level of interleukin-6 at baseline was consistently associated with higher intra-individual variability of blood pressure, including systolic, diastolic, and pulse pressure. Markers of endothelial function (Von Willebrand factor, tissue plasminogen activator), renal function (glomerular filtration rate) and glucose homeostasis (blood glucose, homeostatic model assessment index) were not or to a minor extent associated with blood pressure variability.CONCLUSION: In an elderly population at risk of cardiovascular disease, inflammation (as evidenced by higher levels of interleukin-6) is associated with higher intra-individual variability in systolic, diastolic, and pulse pressure.",

author = "Poortvliet, {Rosalinde K E} and Lloyd, {Suzanne M} and Ian Ford and Naveed Sattar and {de Craen}, {Anton J M} and Wijsman, {Liselotte W} and Mooijaart, {Simon P} and Westendorp, {Rudi G J} and Jukema, {J Wouter} and {de Ruijter}, Wouter and Jacobijn Gussekloo and Stott, {David J}",

year = "2015",

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doi = "10.1093/ajh/hpu181",

language = "English",

volume = "28",

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T1 - Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease

AU - Poortvliet, Rosalinde K E

AU - Lloyd, Suzanne M

AU - Ford, Ian

AU - Sattar, Naveed

AU - de Craen, Anton J M

AU - Wijsman, Liselotte W

AU - Mooijaart, Simon P

AU - Westendorp, Rudi G J

AU - Jukema, J Wouter

AU - de Ruijter, Wouter

AU - Gussekloo, Jacobijn

AU - Stott, David J

PY - 2015/4/1

Y1 - 2015/4/1

N2 - BACKGROUND: Visit-to-visit variability in blood pressure is an independent predictor of cardiovascular disease. This study investigates biological correlates of intra-individual variability in blood pressure in older persons.METHODS: Nested observational study within the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) among 3,794 male and female participants (range 70-82 years) with a history of, or risk factors for cardiovascular disease. Individual visit-to-visit variability in systolic and diastolic blood pressure and pulse pressure (expressed as 1 SD in mm Hg) was assessed using nine measurements over 2 years. Correlates of higher visit-to-visit variability were examined at baseline, including markers of inflammation, endothelial function, renal function and glucose homeostasis.RESULTS: Over the first 2 years, the mean intra-individual variability (1 SD) was 14.4mm Hg for systolic blood pressure, 7.7mm Hg for diastolic blood pressure, and 12.6mm Hg for pulse pressure. After multivariate adjustment a higher level of interleukin-6 at baseline was consistently associated with higher intra-individual variability of blood pressure, including systolic, diastolic, and pulse pressure. Markers of endothelial function (Von Willebrand factor, tissue plasminogen activator), renal function (glomerular filtration rate) and glucose homeostasis (blood glucose, homeostatic model assessment index) were not or to a minor extent associated with blood pressure variability.CONCLUSION: In an elderly population at risk of cardiovascular disease, inflammation (as evidenced by higher levels of interleukin-6) is associated with higher intra-individual variability in systolic, diastolic, and pulse pressure.

AB - BACKGROUND: Visit-to-visit variability in blood pressure is an independent predictor of cardiovascular disease. This study investigates biological correlates of intra-individual variability in blood pressure in older persons.METHODS: Nested observational study within the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) among 3,794 male and female participants (range 70-82 years) with a history of, or risk factors for cardiovascular disease. Individual visit-to-visit variability in systolic and diastolic blood pressure and pulse pressure (expressed as 1 SD in mm Hg) was assessed using nine measurements over 2 years. Correlates of higher visit-to-visit variability were examined at baseline, including markers of inflammation, endothelial function, renal function and glucose homeostasis.RESULTS: Over the first 2 years, the mean intra-individual variability (1 SD) was 14.4mm Hg for systolic blood pressure, 7.7mm Hg for diastolic blood pressure, and 12.6mm Hg for pulse pressure. After multivariate adjustment a higher level of interleukin-6 at baseline was consistently associated with higher intra-individual variability of blood pressure, including systolic, diastolic, and pulse pressure. Markers of endothelial function (Von Willebrand factor, tissue plasminogen activator), renal function (glomerular filtration rate) and glucose homeostasis (blood glucose, homeostatic model assessment index) were not or to a minor extent associated with blood pressure variability.CONCLUSION: In an elderly population at risk of cardiovascular disease, inflammation (as evidenced by higher levels of interleukin-6) is associated with higher intra-individual variability in systolic, diastolic, and pulse pressure.

U2 - 10.1093/ajh/hpu181

DO - 10.1093/ajh/hpu181

M3 - Journal article

C2 - 25298176

SN - 0895-7061

VL - 28

SP - 469

EP - 479

JO - American Journal of Hypertension

JF - American Journal of Hypertension

IS - 4

ER -

Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease

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