Prognostic Relevance of Blood Pressure Variability

摘要: See related article, pp 698–705 Blood pressure (BP) is characterized by marked fluctuations occurring over different time windows (ie, beat to [very short term], within 24 hours [short day [midterm], between visits spaced weeks or months, and seasons, years, even decades [long term]).1 Normally, short-term BP represent an adaptive response of humoral neural mechanisms environmental, behavioral, emotional stimuli. However, experimental clinical studies have shown that increased variability (BPV) may also reflect alterations in cardiovascular regulatory mechanisms, including enhanced sympathetic drive impaired baroreflex function. Several suggested long-term BPV only weakly correlated with thus determinants,1,2 (1) behavioral factors (as changes observed ambulatory levels workdays weekends)3; (2) inconsistent control treatment (mainly poor adherence compliance the patient, as well improper dosing titration antihypertensive treatment); (3) errors measurement, which significantly influence BPVs from visit visit1; (4) seasonal climate-related variables, is, ambient temperature daylight hours, exert important on indicated summer winter.4,5 During past decades, several increasing values (either long term) are associated hypertensive organ damage6 risk, independently average other major confounders7,8 (Figure). When focusing prognostic role BPV, post hoc analyses interventional trials hypertension intraindividual visit-to-visit …