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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
Summary
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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