Effective control of blood pressure (BP) remains a key factor in the reduction of cardiovascular morbidity and mortality. It is shown that regardless of a BP measurement method, a mean BP of at least 5–6 measurements is the most informative for the diagnosis of arterial hypertension. The relationship of high BP variability with the severity of hypertension and the development of target organ damage was indicated. Variability of blood pressure changes on the background of antihypertensive therapy, namely increases while taking short-acting drugs. The article presents systematic reviews and meta-analyzes data concerning the mechanisms of formation, methods of determination and prognostic significance of BP variability.
The aim of the review was to analyze modern concepts of diagnostic and prognostic significance of BP variability in patients with hypertension for selecting the optimal antihypertensive therapy.
Long-term variability of BP is a prognostic significant, it’s necessary to take into account when choosing the optimal treatment for patients with hypertension. Such treatment should not only provide control of BP, but also reduce its variability.
It is shown that the difference in systolic blood pressure over 15 mm Hg can be used as an indicator of the risk of peripheral vascular disease and cardiovascular death. The value of the morning blood pressure increase during its daily monitoring is a strong predictor for stroke, especially in treated patients. The data on the correlation of increased blood pressure variability with increased risk of death in hypertensive patients are presented.
It was underlined that treatment efficacy of patients with hypertension should increase if antihypertensive medications and their combinations reduced blood pressure variability.