Understanding short-term blood-pressure-variability phenotypes: from concept to clinical practice

Abstract

Veerendra Melagireppa Chadachan,1 Min Tun Ye,2 Jam Chin Tay,1 Kannan Subramaniam,3 Sajita Setia4 1Department of General Medicine, Tang Tock Seng Hospital, 2Department of Pharmacy, National University of Singapore, Singapore; 3Global Medical Affairs, Asia-Pacific Region, Pfizer Australia, Sydney, NSW, Australia; 4Medical Affairs, Pfizer, Singapore Abstract: 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. Keywords: hypertension, BPV, HBPM, ABPM, morning surge, nocturnal dipping

Keywords

• Hypertension
• BPV
• HBPM
• ABPM
• morning surge
• nocturnal dipping