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Blood Pressure Variability: Assessment, Predictive Value, and Potential as a Therapeutic Target

  • Blood Pressure Monitoring and Management (J Cockcroft, Section Editor)
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Abstract

A large body of evidence has consistently supported the relationship between blood pressure (BP) levels and the risk of cardiovascular complications. In recent years, several independent studies have also indicated that this risk may not only depend on the magnitude of the blood pressure elevation per se but also on the presence of other associated conditions such as increased blood pressure variability. This concept has been supported by a series of reports, most of which post hoc analyses of clinical trials in hypertension, showing that increasing values of BP variability (BPV) (either in the short term, in the midterm, or in the long term) may predict development, progression, and severity of cardiac, vascular, and renal organ damage, as well as cardiovascular events and mortality. Remarkably, studies conducted in populations at high cardiovascular risk have shown increasing values of BPV in the individual subjects (so-called intra- or within-individual BPV) to be strong predictors of cardiovascular morbidity and mortality, even to a larger extent than average BP values. However, in subjects at low to moderate cardiovascular risk, the contribution of BPV to cardiovascular risk prediction over and beyond average BP values has been shown to be only moderate. The aim of this paper is to critically review the evidence addressing the prognostic relevance of different components of BPV addressing a yet open question, i.e., whether routine assessment of BPV in clinical practice should be regarded as an additional target of antihypertensive treatment to improve cardiovascular protection.

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Gianfranco Parati, Juan Eugenio Ochoa, Carolina Lombardi, and Grzegorz Bilo declare that they have no conflicts of interest.

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  1. Department of Health Sciences, University of Milan–Bicocca, Milan, Italy

    Gianfranco Parati

  2. Department of Cardiovascular Neural and Metabolic Sciences, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy

    Gianfranco Parati, Juan Eugenio Ochoa, Carolina Lombardi & Grzegorz Bilo

  3. Department of Cardiology, S. Luca Hospital, Istituto Auxologico Italiano & University of Milan–Bicocca, Piazza Brescia 20, Milan, 20149, Italy

    Gianfranco Parati

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This article is part of the Topical Collection on Blood Pressure Monitoring and Management

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Parati, G., Ochoa, J.E., Lombardi, C. et al. Blood Pressure Variability: Assessment, Predictive Value, and Potential as a Therapeutic Target. Curr Hypertens Rep 17, 23 (2015). https://doi.org/10.1007/s11906-015-0537-1

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