Blood pressure variability: Measurements, influential factors, prognosis and therapy

Abstract

It was reported that, in addition to blood pressure (BP) level, BP variability could also provide prognostic value of target organ damage, cardiovascular and all-cause mortality. Therefore, evaluation of patients' BP variability could potentially offer guiding information on their clinical therapy. BP variability could be assessed by calculating standard deviation, coefficient of variation and other parameters of BP readings from 24-h ambulatory BP monitor, known as short-term BP variability. More recently, an emerging BP variability can be derived from regular home and office BP recordings for 1 week or several months, known as long-term BP variability. Although the cause and meaning of fluctuated BP was not well elucidated, several factors, including age, mean BP, heart rate variability and arterial stiffness, may influence patients' BP variability. Most clinical investigations indicated a significant prognostic value of either short- or long-term BP variability, with regards to target organ damage, cardiovascular events and mortality, but controversy exists in this field, especially its incremental prognostic value in addition to BP level. Till now, there is no solid evidence indicating any effective agent in terms of BP variability reduction, but some clinical studies favor CCB in reducing both short- and long-term BP variability. Further studies are warranted to investigate the standardized evaluation of patients' BP variation, its cause and added prognostic significance, as well as effective treatment.