Abstract
The complexity and the uncertainties about long-term effect of the invasive interventions to treat essential hypertension (HTN) require a precise diagnosis about the real “resistance” to the antihypertensive treatment given, and it is defined when a therapeutic strategy that includes appropriate lifestyle measures plus a diuretic and two other antihypertensive drugs belonging to different classes at adequate doses fails to lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) values to <140 and 90 mmHg, respectively. Consequently, in the process of diagnosis and follow-up, blood pressure (BP) measurement is the first step that is not exempt of difficulties due to the variability of BP as a parameter. It has long been known that BP is characterized by an array of spontaneous variations. BP values vary markedly within the 24 h because of day-night changes but also because of differences among hours, minutes, and even adjacent beats. They also show variations over more prolonged periods because of differences among days, months, and season [1]. Even though it has been discussed, the prognostic relevance of the different kinds of variability in the case of resistant hypertension is a challenge at the time of evaluation. Several factors have been associated to the high day-to-day variability of patients with resistant hypertension and among them the number of drugs prescribed [2]. Therefore, more precise BP is mandatory in order to take the right decisions.
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Abbreviations
- ABPM:
-
Ambulatory blood pressure monitoring
- BP:
-
Blood pressure
- DBP:
-
Diastolic blood pressure
- HTN:
-
Hypertension
- PWV:
-
Pulse wave velocity
- RDN:
-
Renal denervation
- SBP:
-
Systolic blood pressure
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Redon, J. (2016). Blood Pressure Measurement Before and After Intervention. In: Tsioufis, C., Schmieder, R., Mancia, G. (eds) Interventional Therapies for Secondary and Essential Hypertension. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-34141-5_9
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