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Blood pressure variability in risk stratification: What does it add?
Kei Asayama1, Rudolph Schutte, Yan Li
1Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, KU Leuven, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
Clinical and Experimental Pharmacology & Physiology
|April 12, 2013
Summary
Blood pressure variability does not significantly improve cardiovascular risk prediction beyond blood pressure levels. Focusing on blood pressure level is key for effective risk management and treatment.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Background:
- Blood pressure level is a primary risk factor for cardiovascular disease.
- The role of blood pressure variability (BPV) in cardiovascular risk prediction requires further clarification.
- Existing research often relies on traditional blood pressure measurements.
Purpose of the Study:
- To evaluate the predictive value of blood pressure variability beyond the established blood pressure level.
- To assess novel indices of blood pressure variability, including variability independent of the mean, maximum-minimum difference, and average real variability.
- To determine if morning surge in blood pressure refines cardiovascular risk stratification.
Main Methods:
- Systematic review of studies with sufficient power, long follow-up, and wide age range.
- Analysis of blood pressure variability derived from home visits, self-measured home blood pressure, and 24-hour ambulatory monitoring.
- Inclusion of novel BPV indices and morning surge assessment.
Main Results:
- Novel blood pressure variability indices did not substantially improve risk profiling compared to blood pressure level alone.
- Morning surge in blood pressure also failed to significantly refine risk stratification.
- Blood pressure level remained the predominant factor in risk assessment.
Conclusions:
- Blood pressure level is the most critical and modifiable factor for cardiovascular risk stratification.
- Clinicians should prioritize blood pressure level management through lifestyle changes and antihypertensive medications.
- Current novel indices of blood pressure variability do not offer substantial added value over blood pressure level for risk prediction.
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Physiological Factors:
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