Blood pressure variability and its implications for antihypertensive therapy

P. A. Meredith, D. Perloff, G. Mancia, T. Pickering

Research output: Contribution to journalArticlepeer-review

Abstract

Although it is clear that antihypertensive treatment is beneficial in reducing stroke morbidity and mortality, the results of the major outcome studies show less impact on coronary heart disease. Studies utilizing 24-h blood pressure (BP) monitoring show a positive association between target organ damage and the level of 24-h BP, and with variability in BP, which is an independent determinant of target organ damage. Current understanding of the pathogenesis and pathophysiology of coronary heart disease suggests that optimal antihypertensive treatment should ensure the following: effective 24-h BP control, smooth antihypertensive effect with reduced variability; attenuation of the early morning surge in BP; maintenance of the normal circadian pattern of BP; effective therapeutic coverage in the face of suboptimal compliance; and lack of reflex activation of the sympathetic nervous system. On the basis of our current understanding, this optimum is most likely to be achieved by the use of antihypertensive agents with a long duration of action.

Original languageEnglish
Pages (from-to)5-11
Number of pages7
JournalBlood Pressure
Volume4
Issue number1
DOIs
Publication statusPublished - 1995

Keywords

  • 24-h blood pressure
  • Antihypertensive therapy
  • Blood pressure variability
  • Compliance
  • Hypertension
  • Target organ damage

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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