EFFECT OF INTER-INDIVIDUAL BLOOD PRESSURE VARIABILITY ON THE PROGRESSION OF ATHEROSCLEROSIS IN CAROTID AND CORONARY ARTERIES: A POST HOC ANALYSIS OF THE NORMALISE AND PREVENT STUDIES

Data from two cardiovascular endpoint studies (Norvasc for Regression of Manifest Atherosclerotic Lesions by Intravascular Sonographic Evaluation (NORMALISE) and Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT)) were analysed separately. Systolic BPV was assessed as within-subject standard deviation of systolic BP across visits from 12-weeks onwards. Follow-up was 24 months (NORMALISE) or 36 months (PREVENT). Any association between BPV and progression of atherosclerosis was assessed using quantitative coronary angiography (QCA), intravascular ultrasound (IVUS), or B-mode ultrasound (depending on study). Patients from NORMALISE (n ¼ 261) and PREVENT (n ¼ 688 for QCA; n ¼ 364 for ultrasound) were stratified within study according to median systolic BPV. No significant difference in change of minimal luminal diameter (by QCA in PREVENT) or change in per- cent atheroma volume or normalized total atheroma volume (by IVUS in NORMALISE) was detected for subjects with low BPV (BPV < median) compared with high BPV (BPVmedian), regardless of treatme nt. In PREVENT, as ignif icantly greater reduction in maximum carotid intima-media thickness (IMT) (left and right common carotid artery far wall) was observed for patients with BPV< median compared with those with BPVmedian (least squares mean difference 0.06 (95% confidence interval 0.01, 0.11); P ¼ 0.0271), after adjusting for treatment, carotid artery segment (left or right), baseline maximum carotid IMT, and other baseline and cardiovascular risk factors/covariates.