JMIR Publications

ABSTRACT

Background:

Short-term blood pressure variability (BPV) is associated with arterial stiffness in patients with hypertension. Few studies have examined associations between arterial stiffness and digital home BPV over a mid- to long-term timespan.

Objective:

We aimed to investigate if arterial stiffness traits are associated with subsequent mid- to long-term home BPV in the electronic Framingham Heart Study (eFHS).

Methods:

At an FHS research exam (2016-2019), participants underwent arterial tonometry to acquire measures of arterial stiffness (carotid femoral pulse wave velocity, CFPWV; forward pressure wave amplitude, FWA) and wave reflection (reflection coefficient, RC). Participants who agreed to enroll in eFHS were provided with a digital blood pressure (BP) cuff to measure home BP weekly. Linear regression models were used to examine associations of arterial measures with average real variability (ARV) of home systolic (SBP) and diastolic (DBP) BP adjusting for covariates. We obtained ARV as an average of the absolute differences of consecutive BP measurements. ARV considers not only the dispersion of the BP readings around the mean, but also the order of BP readings.

Results:

Among 857 eFHS participants (mean age 54, SD 9 years; 59% women; 47% hypertension), 1 SD increments in FWA were associated with 0.16 (95%CI: 0.09 to 0.23) SD increments in the ARV of home SBP and 0.08 (95%CI: 0.01 to 0.15) SD increments in the ARV of home DBP; 1 SD increments in RC were associated with 0.14 (95%CI: 0.07, 0.22) SD increments in the ARV of home SBP and 0.11 (95%CI: 0.04 to 0.19) SD increments in the ARV of home DBP.

Conclusions:

In eFHS, higher FWA and RC were associated with higher mid- to long-term ARV of week-to-week home SBP and DBP over one-year follow-up. Our findings suggest that higher aortic stiffness and wave reflection are associated with week-to-week modulation of blood pressure in a home-based setting.