title: [Visit-to-visit variability: Prognostic significance?].
abstract: Hypertension is the most prevalent treatable risk factor for stroke. Treatment of hypertension is based on usual blood pressure, which is evaluated by repeated measurement. When only few measurements show high blood pressure, this is considered as a background noise generally due to white coat effect. Rothwell et al. challenged this notion and presented data from post-hoc analyses of three randomized trials and one meta-analysis, where 3 parameters are strongly associated with the risk of stroke: visit-to-visit variability of systolic blood pressure, increased residual variability in treated patients, and episodic hypertension. These findings are not proof of a causal link between variability and vascular risk. However, a new window has been opened in clinical practice, giving new implications in the choice of treatment, and, for next trials, highlighting the importance of including variability and patients with episodic hypertension.
authors.affiliation: AP-HP, hôpital Hôtel-Dieu, université Paris-Descartes, centre de diagnostic et de thérapeutique, unité hypertension artérielle, prévention et thérapeutique cardiovasculaire, 75004 Paris, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Ly
authors.forename: Davide
authors.initials: D
authors.lastname: Agnoletti
authors.forename: Michel
authors.initials: M
authors.lastname: Safar
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents