Blood pressure variability: assessment, predictive value, and potential as a therapeutic target

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Epidemiology

Background:

• Established link between blood pressure (BP) levels and cardiovascular complications.
• Emerging evidence suggests blood pressure variability (BPV) also impacts cardiovascular risk.
• BPV may be an independent predictor of cardiovascular events and organ damage.

Purpose of the Study:

• To critically review the prognostic relevance of different components of blood pressure variability.
• To address whether routine BPV assessment should be an additional target in antihypertensive treatment.
• To evaluate BPV's role in cardiovascular protection beyond average BP levels.

Main Methods:

• Systematic review of existing literature and post hoc analyses of clinical trials.
• Analysis of studies investigating short-term, mid-term, and long-term BPV.
• Examination of intra-individual BPV in various cardiovascular risk populations.

Main Results:

• Increasing BPV predicts cardiovascular events, organ damage, and mortality, particularly in high-risk groups.
• Intra-individual BPV is a stronger predictor of cardiovascular morbidity and mortality than average BP in high-risk populations.
• BPV's contribution to risk prediction is moderate in low-to-moderate risk individuals.

Conclusions:

• Blood pressure variability is a significant prognostic factor for cardiovascular outcomes.
• The clinical utility of routine BPV assessment as a therapeutic target requires further investigation.
• Understanding BPV's role may refine antihypertensive strategies for enhanced cardiovascular protection.