INSERM, Centre d'Investigations Cliniques-9501, France.
Curr Opin Nephrol Hypertens. 2013 Jan;22(1):59-64. doi: 10.1097/MNH.0b013e32835b489f.
Recent data have highlighted the shortcomings of the usual blood pressure hypothesis in posthoc analyses of randomized controlled trials led in populations at high cardiovascular risk and have emphasized the importance of an increased visit-to-visit variability of blood pressure in predicting cardiovascular events.
Over the last 2 years, the prognostic value of visit-to-visit blood pressure variability has been substantially confirmed in a wide spectrum of clinical populations, in studies investigating both cardiovascular outcomes and target organ damage.
There is an obvious need to design studies to prospectively determine the causes of increased visit-to-visit blood pressure variability, its best estimate and whether or not treatments that reduce blood pressure variability (and to what extent/target) improve clinical outcome.
最近的数据突显了在高心血管风险人群中进行的随机对照试验的事后分析中,常用血压假说的不足,并强调了血压的随访间变异性在预测心血管事件中的重要性。
在过去的 2 年中,在广泛的临床人群中进行的心血管结局和靶器官损害研究中,随访间血压变异性的预后价值得到了充分证实。
显然需要设计前瞻性研究来确定随访间血压变异性增加的原因、其最佳估计值以及降低血压变异性的治疗(以及在何种程度/靶标)是否改善临床结局。