Background: Controversy exists regarding the prognostic relevance of blood pressure variability. Recent evidence suggests that variability is involved in the development of atherosclerosis. We therefore investigated the relationship of structural and functional markers of large arteries with blood pressure variability.

Methods: Our study sample consisted of 1125 randomly selected participants (mean age: 42.4 years; 49.3% women). One trained researcher conducted vascular measurements, including carotid intima-media thickness (IMT), carotid distensibility and carotid–femoral pulse wave velocity (PWV). Systolic blood pressure (SBP) was measured 5 times consecutively. We assessed within-subject variability independent of the mean (VIM).

Results: SBP and VIM averaged 127.9 mm Hg and 3.86 units, while the vascular measurements averaged 0.70 mm, 6.62 m/s and 24.7 10⁻³/kPa for IMT, PWV and carotid distensibility, respectively.

In single regression, IMT correlated with SBP (r=0.27, p<0.0001) and VIM (r=0.22; p<0.0001). Similarly, PWV and the carotid distensibility correlated with both SBP (PWV, r=0.34; p<0.0001; carotid distensibility, r= –0.32, p<0.0001) and VIM; however, the associations with VIM were weaker (PWV, r=0.07; p=0.025; carotid distensibility, r= –0.09, p=0.003). After adjusting for sex and age, and other covariables, the associations of IMT with SBP (β=0.029, p<0.0001) and VIM (β=0.036, p<0.0001) remained. However, those between PWV (β=0.044, p=0.45), carotid distensibility (β= –0.53, p=0.28) and VIM disappeared. PWV (β=0.353, p<0.0001) and carotid distensibility (β= –2.92, p<0.0001) remained associated with SBP.

Conclusion: In the FLEMENGHO cohort, blood pressure variability relates to carotid IMT, but not the indexes of arterial stiffness.