Long-Term blood pressure variability in young adulthood and coronary artery calcium and carotid intima-media thickness in midlife: The cardia study

Chike C. Nwabuo, Yuichiro Yano, Henrique T. Moreira, Duke Appiah, Henrique D. Vasconcellos, Queen N. Aghaji, Anthony J. Viera, Jamal S. Rana, Ravi V. Shah, Venkatesh L. Murthy, Norrina B. Allen, Pamela J. Schreiner, Donald M. Lloyd-Jones, João A.C. Lima*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Recent evidence links long-Term (visit-To-visit) blood pressure (BP) variability to the risk of cardiovascular disease, independent of mean BP levels. Potential associations between long-Term BP variability and cardiovascular disease risk may be reflected in early life course alterations in coronary artery calcium (CAC) and carotid intima-media thickness. We evaluated 2482 CARDIA study (Coronary Artery Risk Development in Young Adults) participants (mean [SD] age at the year 20 exam [2005-2006] was 45.4 [3.6] years, 43.2% men, and 41.3% black). We included participants with BP assessments across 20-years (year 0, 2, 5, 7, 10, 15, 20 exams) and carotid intima-media thickness and CAC data at the year 20 exam. BP variability was assessed using variability independent of the mean and SD. Adjusted multivariable linear or logistic regression models (as appropriate) were used to assess associations between long-Term BP variability measures and carotid intima-media thickness. and CAC (ln [CAC+1] and prevalent CAC). Long-Term systolic BP variability independent of the mean (per 1 SD) was positively associated with carotid intima-media thickness (β=10 μm, SE=3, P=0.002). Similarly, long-Term diastolic BP variability independent of the mean was associated with carotid intima-media thickness (β=10 μm, SE (3), P=0.001). Long-Term BP variability was not associated with either ln [CAC+1] or prevalent CAC. Long-Term systolic and diastolic BP variability across early adulthood was positively associated with modest adverse midlife alterations in carotid intima-media thickness but not to CAC. Our findings provide further insights into pathophysiologic mechanisms that link long-Term BP variability to cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)404-409
Number of pages6
JournalHypertension
DOIs
StatePublished - Aug 1 2020

Keywords

  • atherosclerosis
  • blood pressure
  • calcium
  • cardiovascular disease
  • carotid intima-media thickness

ASJC Scopus subject areas

  • Internal Medicine

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    Nwabuo, C. C., Yano, Y., Moreira, H. T., Appiah, D., Vasconcellos, H. D., Aghaji, Q. N., Viera, A. J., Rana, J. S., Shah, R. V., Murthy, V. L., Allen, N. B., Schreiner, P. J., Lloyd-Jones, D. M., & Lima, J. A. C. (2020). Long-Term blood pressure variability in young adulthood and coronary artery calcium and carotid intima-media thickness in midlife: The cardia study. Hypertension, 404-409. https://doi.org/10.1161/HYPERTENSIONAHA.120.15394