Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Dec 24, 2022
Open Peer Review Period: Dec 24, 2022 - Jan 7, 2023
Date Accepted: May 24, 2023
(closed for review but you can still tweet)
Temporal and bidirectional association between blood pressure variability and arterial stiffness: a cross-lagged cohort study
ABSTRACT
Background:
The casual relationship between blood pressure variability (BPV) and arterial stiffness remained debating.
Objective:
This study aimed to explore the temporal and bidirectional associations between long-term BPV and arterial stiffness using a cohort design with multiple surveys.
Methods:
Participants underwent health examinations from visit 1 (2010-2011) to visit 5 (2018-2019) were enrolled from Beijing Health Management Cohort. The long-term BPV was defined as intra-individual variation using coefficient of variation (CV) and standard deviation (SD). Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV). The bidirectional relationship between BPV and arterial stiffness was explored using cross-lagged analysis and linear regression model, with records before and after visit 3 as phase 1 and phase 2.
Results:
Of the 1506 participants (mean [SD] age, 56.11 [8.57] years), 1148 (76.2%) were male. The cross-lagged analysis indicated the standardized coefficients of BPV at phase 1 directing to baPWV level at phase 2 were statistically significant, not vice versa. The adjusted regression coefficients (95% CI) of the CV were 4.708 (0.946 to 8.470) for systolic pressure, 3.199 (0.166 to 6.073) for diastolic pressure, and 2.205 (0.300 to 4.110) for pulse pressure. The coefficients of the SD were 4.208 (0.177 to 8.239) for diastolic pressure, and 4.247 (0.488 to 8.046) for pulse pressure. The associations were predominant in hypertensive subgroup, while we did not observe any significant association of baPWV level with subsequent BPV indices.
Conclusions:
The findings supported a temporal relationship from long-term BPV to arterial stiffness level, especially in the hypertensive population.
Citation
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