Aoyama Rie, Takano Hitoshi, Suzuki Keishi, Kubota Yoshiaki, Inui Keisuke, Tokita Yukichi, Shimizu Wataru
Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
Coron Artery Dis. 2017 May;28(3):225-231. doi: 10.1097/MCA.0000000000000462.
Blood pressure variability (BPV), especially visit-to-visit BPV, has been reported to be a risk factor for cardiovascular disease. The impact of BPV on coronary plaque vulnerability remains uncertain. The aim of this study was to investigate the relationship between BPV and coronary plaque vulnerability.
From August 2013 to May 2014, 36 patients with both hypertension and stable angina pectoris who underwent a percutaneous coronary intervention guided by frequency-domain optical coherence tomography were investigated retrospectively. The size of the lipid cores and the thickness of the fibrous cap covering the lipid core were measured by frequency-domain optical coherence tomography, and we calculated the blood pressure coefficient of variation (CV) and SD as intraindividual visit-to-visit BPV.
Both SD and CV of systolic blood pressure (SBP) correlated positively with lipid arc (SBP-SD: r=0.68, P<0.01; SBP-CV: r=0.64, P<0.01) as well as average SBP (r=0.48, P<0.01). Fibrous cap thickness did not correlate with blood pressure variables or BPV.
BPV is related to coronary plaque volume, but not to coronary plaque vulnerability. In addition to conventional coronary risk factors, BPV may be a therapeutic target for coronary atherosclerosis.
血压变异性（BPV），尤其是就诊间血压变异性，已被报道为心血管疾病的一个危险因素。BPV对冠状动脉斑块易损性的影响仍不确定。本研究的目的是探讨BPV与冠状动脉斑块易损性之间的关系。
回顾性研究了2013年8月至2014年5月期间36例同时患有高血压和稳定型心绞痛且接受频域光学相干断层扫描引导下经皮冠状动脉介入治疗的患者。通过频域光学相干断层扫描测量脂质核心的大小和覆盖脂质核心的纤维帽厚度，并计算血压变异系数（CV）和标准差作为个体内就诊间BPV。
收缩压（SBP）的标准差和CV均与脂质弧呈正相关（SBP-SD：r=0.68，P<0.01；SBP-CV：r=0.64，P<0.01）以及平均SBP（r=0.48，P<0.01）。纤维帽厚度与血压变量或BPV无相关性。
BPV与冠状动脉斑块体积相关，但与冠状动脉斑块易损性无关。除了传统的冠状动脉危险因素外，BPV可能是冠状动脉粥样硬化的一个治疗靶点。
