The importance of instability and visit-to-visit variability of blood pressure.
Spontaneous fluctuations of blood pressure from visit to visit have usually been disregarded as a trivial factor that confounds the 'true' associations of an individual's long-term average blood pressure with disease. The paper under evaluation shows that visit-to-visit blood pressure variability is an independent predictor of future cardiovascular events in hypertensive patients and in subjects surviving a transient cerebral ischemia. Episodic elevations of blood pressure in nonhypertensive subjects seem to carry similar adverse prognostic significance. There is some evidence that different blood pressure-lowering drug classes may differ in their effects on visit-to-visit blood pressure variability, but these findings need to be confirmed in further studies.
Schillaci
Giuseppe
G
Internal Medicine, Angiology and Arteriosclerosis Disease, University of Perugia Medical School, Hospital Santa Maria della Misericordia, piazzale Menghini, 1 IT-06129 Perugia, Italy. skill@unipg.it
Pucci
Giacomo
G