Blood pressure variability: Epidemiological and clinical issues

Abstract

Blood pressure variability (BPV) is a classical physiological phenomenon. This paper describes
major epidemiological and clinical issues of BPV which may be important to understand the
background of this interesting feature. In healthy subjects, BPV is a measure of hemodynamic
condition and refl ects function of autonomic nervous system. BP fl uctuations result from the
complex interaction between environmental stimulation, genetic factors and cardiovascular
control mechanisms. Abnormal BPV is recognized in persons with a blurred dipping pattern
(i.e. extreme dipping, non-dipping, reverse-dipping, morning surge of BP) or increased variations
of day-time or night-time BP (high BP lability). Inappropriate BPV worsens the outcome,
including increase in all-cause and cardiac mortality and incidence of cardiovascular events,
and advance in target organ damage. Abnormal BPV may be softened or removed with suitable
time-dependent administration of anti-hypertensive agents, especially those acting on the
renin–angiotensin system.