Intima–Media Thickness Is Linearly and Continuously Associated With Systolic Blood Pressure in a Population‐Based Cohort (STANISLAS Cohort Study)

• Published in: Journal of the American Heart Association Vol. 5; no. 6
• Main Authors: Ferreira, João Pedro, Girerd, Nicolas, Bozec, Erwan, Machu, Jean Loup, Boivin, Jean‐Marc, London, Gérard M., Zannad, Faiez, Rossignol, Patrick
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 01-06-2016; Wiley
• Subjects: Adolescent; Adult; Aged; ambulatory blood pressure monitoring; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - physiology; Carotid Intima-Media Thickness; Cohort Studies; Cross-Sectional Studies; Female; Humans; hypertension; Hypertension - diagnostic imaging; Hypertension - physiopathology; intima–media thickness; linear associations; Male; Middle Aged; Original Research; Risk Factors; Young Adult; ambulatory blood pressure monitoring; intima–media thickness; hypertension; linear associations
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.116.003529

Background
Carotid intima–media thickness (cIMT) is a noninvasive marker of cardiovascular risk. The cIMT may be increased in patients with harmonisation, but little is known regarding the functional form of the association between blood pressure (BP) and cIMT in hypertensive and nonhypertensive persons. We aimed to define the shape of the association between BP and cIMT.
Methods and Results
We studied cIMT and ambulatory BP monitoring data from a single‐center, cross‐sectional, population‐based study involving 696 adult participants from the STANISLAS cohort, a familial longitudinal cohort from the Nancy region of France. Participants with a history of hypertension were more likely to have a cIMT >900 μm and had higher mean cIMT (both P<0.001). The risk of cIMT >900 μm increased linearly with higher 24‐hour and daytime systolic BP in participants both with and without history of hypertension. The relationship between systolic BP and the risk of cIMT >900 μm was not dependent on hypertension status (all P for interaction >0.10). In multivariable analysis adjusted on cardiovascular risk factors, each 5‐mm Hg increase in systolic BP was associated with an 8‐μm increase in cIMT (β=8.249 [95% CI 2.490–14.008], P=0.005). In contrast, the association between diastolic BP and cIMT was weaker and not significant.
Conclusions
Systolic BP is linearly and continuously associated with higher cIMT in both hypertensive and nonhypertensive persons, suggesting a detrimental effect of BP on the vascular tree prior to overt hypertension. Similarly, it suggests a detrimental effect of BP at the higher end of the normal range in treated hypertensive patients.
Clinical Trial Registration
URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01391442.