title: Does blood pressure variability contribute to risk stratification? Methodological issues and a review of outcome studies based on home blood pressure.
abstract: This review addresses methodological issues in the assessment of blood pressure variability and the predictive value of blood pressure variability derived from blood pressure readings obtained in the relaxed home environment. Preference should be given to indexes of blood pressure variability that are independent of the mean because we should evaluate the impact of blood pressure variability by eliminating the effect of blood pressure levels. Beat-to-beat blood pressure recordings outperform home blood pressure measurement in the assessment of blood pressure variability in longitudinal Belgian and Japanese population studies, whereas blood pressure variability did not incrementally predict outcome beyond blood pressure level and other cardiovascular risk factors. In conclusion, clinicians should focus on blood pressure level, given that it is the predominant risk factor and is manageable by lifestyle modifications and adequate antihypertensive drug treatment. Blood pressure variability remains a research tool that requires further prospective studies with hard end points to define its potential application, as it may be potentially useful in daily clinical practice.
authors.affiliation: 1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.affiliation: 1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Fang-Fei
authors.initials: FF
authors.lastname: Wei
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Liu
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Gu
authors.affiliation: 1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
authors.forename: Rudolph
authors.initials: R
authors.lastname: Schutte
authors.affiliation: Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Thijs
authors.affiliation: 1] Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] VitaK Research and Development, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D011379:Prognosis; D012306:Risk; D018570:Risk Assessment