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Assessing the prognostic relevance of blood pressure variability: discrepant information from different indices

Methods to assess blood pressure variability Analysis of 24-h ambulatory blood pressure recordings, obtained in hypertensive patients, has demonstrated that a greater blood pressure variability is associated with either a greater degree of end-organ damage [1–6] and/or a higher rate of cardiovascular events [5–8]. This was often, but not invariably, the case even after accounting for between-subject differences in mean blood pressure levels [2–5,7,8]. In most of these studies, information on the adverse effects of an increased blood pressure variability was obtained by quantifying this phenomenon as the SD of 24-h average ambulatory blood pressure. However, calculation of 24-h blood pressure SD does not provide a fully satisfactory quantification of the features characterizing blood pressure variations over 24 h.