Antihypertensive Therapy: Renal Injury (MR Weir and GL Bakris, Section Editors)

Current Hypertension Reports

, Volume 14, Issue 5, pp 421-431

Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

  • Gianfranco ParatiAffiliated withCardiology and Department of Clinical Medicine and Prevention, University of Milan-BicoccaDepartment of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano Email author 
  • , Juan E. OchoaAffiliated withDepartment of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico ItalianoDepartment of Clinical Medicine and Prevention, University of Milan-Bicocca
  • , Grzegorz BiloAffiliated withDepartment of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano

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Abstract

The adverse cardiovascular consequences of high blood pressure (BP) not only depend on absolute BP values, but also on BP variability (BPV). Evidence has been provided that independently of mean BP levels, BP variations in the short- and long-term are associated with the development, progression and severity of cardiac, vascular and renal organ damage, and with an increased risk of CV events and mortality. Alterations in BPV have also been shown to be predictive of the development and progression of renal damage, which is of relevance if considering that impaired renal function in a hypertensive patient constitutes a very potent predictor of future CV events and mortality even in treated subjects. This review will address whether antihypertensive treatment should target alterations in BPV, in addition to reducing absolute BP levels, in order to achieve the highest CV and renal protection in hypertensive and renal patients.

Keywords

Hypertension Blood pressure BP Short- and long-term BP variability Cardiovascular risk Cardiovascular morbidity and mortality Renal disease progression End-stage renal disease ESRD Chronic kidney disease CKD Arterial hypertension Ambulatory BP monitoring Home BP monitoring Antihypertensive treatment