Blood pressure variability: clinical relevance and application

Abstract

Blood pressure variability is an entity that characterizes the continuous and dynamic fluctuations that occur in blood pressure levels throughout a lifetime. This phenomenon has a complex and yet not fully understood physiological background and can be evaluated over time spans ranging from seconds to years. The present paper provides a short overview of methodological aspects, clinical relevance, and potential therapeutic interventions related to the management of blood pressure variability.

Keywords: Blood pressure monitoring; Blood pressure variability; Hypertension; organ damage; vardiovascualar events.

Figure 1

Various types of BPV, their determinants, and prognostic relevance for cardiovascular and renal outcomes. From Parati et al1 by permission. *Assessed in laboratory conditions; ^‡cardiac, vascular, and renal subclinical organ damage; ^§ BPV on a beat‐to‐beat basis has not been routinely measured in population studies. Abbreviations: AHT, antihypertensive treatment; BP, blood pressure; BPV, blood‐pressure variability; ESRD, end‐stage renal disease; eGFR, estimated glomerular filtration rate

Figure 2

Opposite impact on cardiovascular mortality of day–night change in diastolic blood pressure (DBP; left) and of “erratic” residual DBP variability (right). Kaplan‐Meier curves are shown for subjects with values above (black lines) and below (gray lines) the population median. From Mancia et al7 used by permission