Key result
Short-term BP variability phenotypes are linked to increased CV risk, best assessed using ABPM.
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Recognizing short-term blood pressure variability phenotypes beyond clinic readings is critical for optimal hypertension management and cardiovascular risk reduction.
Clinic blood pressure (BP) is recognized as the gold standard for the screening, diagnosis, and management of hypertension. However, optimal diagnosis and successful management of hypertension cannot be achieved exclusively by a handful of conventionally acquired BP readings. It is critical to estimate the magnitude of BP variability by estimating and quantifying each individual patient's specific BP variations. Short-term BP variability or exaggerated circadian BP variations that occur within a day are associated with increased cardiovascular events, mortality and target-organ damage. Popular concepts of BP variability, including "white-coat hypertension" and "masked hypertension", are well recognized in clinical practice. However, nocturnal hypertension, morning surge, and morning hypertension are also important phenotypes of short-term BP variability that warrant attention, especially in the primary-care setting. In this review, we try to theorize and explain these phenotypes to ensure they are better understood and recognized in day-to-day clinical practice.
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Chadachan et al. (2018) conducted a review in Hypertension and Blood Pressure Variability. Out-of-office blood pressure monitoring (ABPM and HBPM) vs. Office blood pressure monitoring was evaluated. Short-term blood pressure variability phenotypes, such as nocturnal hypertension and morning surge, are associated with increased cardiovascular risk and are best assessed using ambulatory or home blood pressure monitoring.
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