Blood pressure variability in risk stratification: What does it add?

Abstract

Summary: In this minireview we address the predictive value of blood pressure variability, over and beyond level of pressure, in randomly selected population samples. All reviewed studies had sufficient power, long follow-up duration and a wide age range. We assessed blood pressure variability derived from home visit, self-measured home pressure and 24 h ambulatory monitoring. The conclusions are based mainly on novel indices of blood pressure variability: variability independent of the mean, difference between maximum and minimum blood pressure and average real variability. None of these variability indices or morning surge in blood pressure substantially refined risk profiling over and beyond the blood pressure level. In risk stratification, clinicians should concentrate on blood pressure level, the predominant risk factor modifiable by lifestyle measures and antihypertensive drug treatment. Clinical and Experimental Pharmacology and Physiology © 2013 Wiley Publishing Asia Pty Ltd 41 1 January 2014 10.1111/1440-1681.12091 Frontiers in Research Review: Ambulatory and Home Blood Pressure Measurement in the Management of Hypertension Frontiers in Research Review: Ambulatory and Home Blood Pressure Measurement in the Management of Hypertension © 2013 Wiley Publishing Asia Pty Ltd.