In many individuals, blood pressure varies between clinic visits conducted days, weeks, or months apart. This visit-to-visit variability (VVV) of blood pressure has been recently related with an increased risk of coronary heart disease, stroke, and mortality, independently of mean blood pressure. As for other chronical diseases, patients’ adherence to hypertensive therapies remains low and partial adherence to antihypertensive treatment may constitute a source of VVV, as suggested by recent studies. This data should lead to a new clinical approach for hypertension care, based on patients’ real adherence to treatment. Therapeutic strategies should include patients’ adherence. In this context, the role of community pharmacists for patients’ follow-up of hypertension should be reinforced, as they represent efficient and easily accessible health professionals.
Blood pressure variability Clinical pharmacy Hypertension care
This is a preview of subscription content, log in to check access
Conflicts of interest
The authors declared that they have no conflict of interest.
Rothwell PM, Howard SC, Dolan E, O’Brien E, Dobson JE, Dahlof B, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375:895–905.CrossRefPubMedGoogle Scholar
Stevens SL, Wood S, Koshiaris C, Law K, Glasziou P, Stevens RJ, et al. Blood pressure variability and cardiovascular disease: systematic review and meta-analysis. BMJ. 2016;354:i4098.CrossRefPubMedPubMedCentralGoogle Scholar
Hastie CE, Jeemon P, Coleman H, McCallum L, Patel R, Dawson J, et al. Long-term and ultra long-term blood pressure variability during follow-up and mortality in 14,522 patients with hypertension. Hypertension. 2013;62:698–705.CrossRefPubMedGoogle Scholar
Bouissou-Schurtz C, Lindesay G, Regnault V, Renet S, Safar ME, Molinie V, et al. Development of an experimental model to study the relationship between day-to-day variability in blood pressure and aortic stiffness. Front Physiol. 2015;6:368.CrossRefPubMedPubMedCentralGoogle Scholar
Murphy PZ, Sands C, Ford F. Effectiveness of a pharmacist-led cardiovascular risk reduction clinic in rural perry county, alabama. Int J Chron Dis. 2016;2016:4304761.Google Scholar
Bajorek B, Lemay KS, Magin P, Roberts C, Krass I, Armour CL. Implementation and evaluation of a pharmacist-led hypertension management service in primary care: outcomes and methodological challenges. Pharm Pract. 2016;14:723.CrossRefGoogle Scholar
Bogden PE, Abbott RD, Williamson P, Onopa JK, Koontz LM. Comparing standard care with a physician and pharmacist team approach for uncontrolled hypertension. J Gen Int Med. 1998;13:740–5.CrossRefGoogle Scholar
Cheema E, Sutcliffe P, Singer DR. The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials. Br J Clin Pharmacol. 2014;78:1238–47.CrossRefPubMedPubMedCentralGoogle Scholar