%0 Journal Article
%T Blood Pressure Variability: Prognostic Value and Therapeutic Implications
%A Christian H£¿cht
%J ISRN Hypertension
%D 2013
%R 10.5402/2013/398485
%X Blood pressure variability (BPV) is considered nowadays a novel risk factor for cardiovascular disease. Early findings in sinoaortic denervated rats have clearly shown that enhanced fluctuation of blood pressure induced left ventricular hypertrophy, vascular stiffness, and renal lesion. A large number of clinical trials confirm that short-term and long-term blood pressure variability independently contributes to target organ damage, cardiovascular events, and mortality not only in hypertensive patients but also in subjects with diabetes mellitus and chronic kidney disease. Therefore, amelioration of BPV has been suggested as an additional target of the treatment of cardiovascular diseases. Preliminary evidence obtained from meta-analysis and controlled clinical trials has shown that antihypertensive classes differ in their ability to control excessive BP fluctuations with an impact in the prevention of cardiovascular events. Calcium channel blockers seem to be more effective than other blood pressure lowering drugs for the reduction of short-term and long-term BPV. In order to increase actual knowledge regarding the prognostic value and therapeutic significance of BPV in cardiovascular disease, there is a need for additional clinical studies specifically designed for the study of the relevance of short-term and long-term BPV control by antihypertensive drugs. 1. Introduction The role of high blood pressure levels on target organ damage and the protective effects of antihypertensive therapy have been extensively established in clinical practice [1]. Mortality from ischemic heart disease and stroke doubles every increment in 20 and 10£¿mmHg of systolic and diastolic blood pressure [1]. Nowadays, it is clear that besides usual blood pressure other parameters contribute to TOD in hypertensive patients [2]. Blood pressure is not a constant variable; rather, it shows marked spontaneous oscillations over short-term (minutes to days) and long-term (month) periods [3]. Early reports from animal models of cardiovascular variability have clearly demonstrated the relationship between excessive fluctuation in blood pressure values and the development of target organ damage [4]. The initial hypothesis was further corroborated by clinical studies in hypertensive subjects showing that the assessment and quantification of blood pressure variability (BPV) is of physiopathological and prognostic importance [5]. In recent years, a large number of preclinical and clinical studies have clearly identified the contribution of BPV to the cardiovascular complications associated
%U http://www.hindawi.com/journals/isrn.hypertension/2013/398485/