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Abstract
Blood pressure values are characterized by marked fluctuations occurring not only within a 24-hour period, but also on a day-to-day and even visit-to-visit basis. Such blood pressure fluctuation was once considered ‘background noise' or a randomly occurring phenomenon; however, recently it is widely accepted that these variations are the result of complex interactions between extrinsic environmental and behavioral factors and intrinsic cardiovascular regulatory mechanisms. Although adverse cardiovascular consequences of hypertension largely depend on absolute blood pressure values, variations in blood pressure also have predictive value for cardiovascular events. Post-hoc analyses of large intervention trials in hypertension have shown that within-patient visit-to-visit blood pressure variation is strongly prognostic for cardiovascular morbidity and mortality, especially in high-risk patients, suggesting that antihypertensive treatment should be targeted not only towards reducing mean blood pressure levels but also to stabilizing blood pressure variability.
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