Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan.
Curr Hypertens Rep. 2016 Oct;18(10):75. doi: 10.1007/s11906-016-0680-3.
The study aims to summarize the effect of antihypertensive therapy on various types of BP variability in hypertensives.
Visit-to-visit, day-by-day, and ambulatory BPV are markers of target organ damage and cardiovascular prognosis, as was shown in the LIFE study, which showed that visit-to-visit variability in BP predicted cardiovascular events in treated hypertensive patients with left ventricular hypertrophy. Long-acting calcium channel blockers (CCBs) may be a preferable treatment in reducing BPV measures. Non-adherence to antihypertensive medication is also a very important component of increased BPV, and improving the adherence is also a key for the favorable prognosis. BPV cannot be a target of antihypertensive treatments because of the lack of definitive evidence. However, in high-risk patients, those with cardiovascular or cerebrovascular diseases, the clinical significance should be considered in individual basis. Especially, reduction of BPV would be an important strategy for these patients.
研究旨在总结降压治疗对高血压患者各种类型血压变异性的影响。
动态血压监测（ABPM）显示，诊室血压变异性（BPV）、日间血压变异性和夜间血压变异性是靶器官损害和心血管预后的标志物，LIFE 研究表明，左心室肥厚的高血压患者的 BP 诊室血压变异性可预测心血管事件。长效钙通道阻滞剂（CCB）可能是降低血压变异性的更优治疗选择。降压药物治疗不依从也是血压变异性增加的一个非常重要的因素，提高依从性也是有利预后的关键。由于缺乏明确的证据，血压变异性不能作为降压治疗的目标。然而，在高危患者中，有心血管或脑血管疾病的患者，应根据个体情况考虑其临床意义。特别是，降低血压变异性将是这些患者的重要策略。
