Abstract: Objective To assess the relationship between visit-to-visit blood pressure (BP) variability (BPV) and vascular
endothelial function in a cohort of elderly hypertensive patients. Methods A total of 174 elderly patients with essential
hypertension were included in the study. The participants had their office BP measured during the 12-month follow-up. Right
brachial artery diameter was assessed at rest, during reactive hyperemia (flow-mediated dilation, FMD), and after
nitroglycerin administration (nitroglycerin-mediated dilation, NMD). The participants were divided into two groups
according to FMD% or FMD/NMD ratio. The correlations between BPV and endothelial function were analyzed by univariate
analysis and multiple linear regression analysis． Results The participants classified as having a decreased endothelial
function according to FMD/NMD ratio had significantly lower FMD% and higher BPV and NMD% (P<0.05). The percentage of
CCBs use in normal endothelial function group was significantly higher than that in decreased endothelial function group
(79.55% vs 63.95%, P<0.05). Multiple linear regression analysis revealed a significant negative association between FMD/NMD
ratio and BPV, and this association remained significant after adjustment for age, body mass index, and mean BP levels.
Conclusions FMD/NMD ratio is a better marker of endothelial function than FMD, and an increased visit-to-visit variability of
BP is associated with a decreased endothelial function.