Long-term blood pressure variability: an emerging cardiovascular risk factor

Area of Science:

• Cardiology
• Hypertension Research

Background:

• Long-term systolic blood pressure variability (SBPV) is a significant predictor of cardiovascular outcomes.
• High SBPV increases cardiovascular risk, even in patients with well-controlled blood pressure (<140/90 mmHg).

Purpose of the Study:

• To highlight the prognostic significance of systolic blood pressure variability.
• To discuss methods of measuring SBPV and potential alternatives.
• To identify antihypertensive medications that effectively reduce SBPV.

Main Methods:

• Analysis of data from clinical trials and observational studies.
• Derivation of SBPV using standard deviation of visit-to-visit clinic blood pressure measurements.
• Review of evidence on antihypertensive drug effects on SBPV.

Main Results:

• SBPV is an independent predictor of cardiovascular outcomes, irrespective of average systolic pressure levels.
• Values exceeding 12 for SBPV indicate high risk.
• Ongoing research is exploring home blood pressure monitoring for SBPV assessment.

Conclusions:

• Long-acting calcium-channel blockers (e.g., amlodipine) and thiazide-like diuretics are the primary antihypertensive drug classes shown to reduce long-term SBPV.
• These medications should be prioritized for patients exhibiting high SBPV.