Calcium antagonist added to angiotensin receptor blocker: A recipe for reducing blood pressure variability?: Evidence from day-by-day home blood pressure monitoring

摘要

The results of a number of studies performed over the years support the hypothesis that short-term blood pressure (BP) variability (BPV) assessed within 24 hours is an independent determinant of organ damage and cardiovascular events in hypertension. More recently, a few articles have raised interest also in BP fluctuations occurring over longer time periods. Rothwell et al assessed the variability in clinic BP or in average 24-hour ambulatory BP values occurring between visits. They analyzed previously collected data demonstrating an independent association of such visit-to-visit variability with (mainly) cerebrovascular events. The principal disadvantage of this approach, however, is its limited applicability in the daily management of hypertensive patients, where it is difficult to obtain BP data under a stable antihypertensive treatment regimen over a consistent number of visits. An alternative method, devoid of this difficulty, is to assess day-by-day BPV making use of home BP values obtained over several days. Its validity is supported by studies demonstrating the relationship of day-by-day BPV with cardiovascular outcomes.