The Individual and Joint Associations of Systolic Blood Pressure Variability and Arterial Stiffness with Cardiovascular Disease: A Prospective Cohort Study

Ming Gao; Wei Pan; Tianqi Ma; Qunyong Pen; Rong Cao; Chenxuan Zhao; Jun Yi

doi:10.1007/s12265-025-10644-9

The Individual and Joint Associations of Systolic Blood Pressure Variability and Arterial Stiffness with Cardiovascular Disease: A Prospective Cohort Study

J Cardiovasc Transl Res. 2025 Jun 20. doi: 10.1007/s12265-025-10644-9. Online ahead of print.

Authors

Ming Gao^{1

2}, Wei Pan¹, Tianqi Ma¹, Qunyong Pen², Rong Cao³, Chenxuan Zhao³, Jun Yi⁴

Affiliations

¹ Department of Cardiology, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, 410008, China.
² Department of Geriatric Medicine, Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, 410008, China.
³ Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
⁴ Department of Cardiology, Center of Coronary Circulation, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, 410008, China. yjwx0312@163.com.

PMID: 40540207
DOI: 10.1007/s12265-025-10644-9

Abstract

Systolic blood pressure variability (SBPV) and arterial stiffness index (ASI) are risk factors for cardiovascular diseases (CVD), but their independent and combined effects remain unclear. This study investigated their associations using data from 28,792 UK Biobank participants without CVD at baseline. SBPV and ASI were categorized into quartiles, and Cox regression was used to assess their effects on CVD risk. Over an average follow-up of 12.29 years, 3,967 CVD events occurred. Higher SBPV and ASI were independently associated with increased CVD risk (SBPV Q4: HR 1.25 [1.14-1.38]; ASI Q4: HR 1.24 [1.12-1.36]). A multiplicative interaction was observed (p = 0.019), and their combined effect further elevated risk (SBPV Q4 + ASI Q4: HR 1.63 [1.32-2.02]). These findings suggest SBPV and ASI independently and jointly contribute to CVD risk, highlighting the need for targeted interventions.

Keywords: Arterial stiffness index; Cardiovascular disease; Systolic blood pressure variability.