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Blood pressure variability and its implications for antihypertensive therapy

P A Meredith1, D Perloff, G Mancia

  • 1Department of Medicine and Therapeutics, University of Glasgow, Scotland.

Blood Pressure
|January 1, 1995
PubMed

Insights

Antihypertensive treatments effectively reduce stroke but have less impact on coronary heart disease. Long-acting agents are recommended for optimal blood pressure control and reduced cardiovascular risk.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Pharmacology

Background:

  • Antihypertensive treatment significantly reduces stroke but shows limited benefits for coronary heart disease.
  • 24-hour blood pressure monitoring reveals target organ damage is linked to 24-hour blood pressure levels and variability.
  • Blood pressure variability is an independent determinant of target organ damage.

Purpose of the Study:

  • To outline the characteristics of optimal antihypertensive treatment for coronary heart disease.
  • To identify antihypertensive agents that provide effective 24-hour blood pressure control and minimize variability.
  • To address the need for treatments that manage early morning blood pressure surges and maintain circadian patterns.

Main Methods:

  • Review of major outcome studies on antihypertensive treatment.
  • Analysis of data from 24-hour ambulatory blood pressure monitoring.
  • Evaluation of the pathophysiology of coronary heart disease in relation to blood pressure control.

Main Results:

  • Current antihypertensive strategies show limited efficacy in preventing coronary heart disease.
  • Blood pressure variability and high 24-hour blood pressure are associated with target organ damage.
  • Optimal treatment requires sustained 24-hour blood pressure control, reduced variability, and management of circadian BP patterns.

Conclusions:

  • Optimal antihypertensive therapy should focus on effective 24-hour blood pressure control and reduced variability.
  • Long-acting antihypertensive agents are most likely to achieve the desired therapeutic profile.
  • Consideration of circadian blood pressure patterns and patient compliance is crucial for effective cardiovascular risk reduction.

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