Assessment and interpretation of blood pressure variability in a clinical setting

Blood Pressure

Volumn 22, Issue 6, 2013, Pages 345-354

  Parati, Gianfranco ^a,b   Ochoa, Juan Eugenio ^a,b   Lombardi, Carolina ^b   Salvi, Paolo ^b   Bilo, Grzegorz ^b  

^a UNIVERSITY OF MILANO BICOCCA   (Italy)

^b ISTITUTO AUXOLOGICO ITALIANO   (Italy)

Author keywords

Ambulatory BP monitoring; Antihypertensive treatment; Arterial hypertension; Blood pressure; BP; Cardiovascular morbidity and mortality; Cardiovascular risk; Home BP monitoring; Short and long term BP variability

Indexed keywords

ANTIHYPERTENSIVE AGENT;

BLOOD PRESSURE MEASUREMENT; BLOOD PRESSURE VARIABILITY; CARDIOVASCULAR DISEASE; CARDIOVASCULAR MORTALITY; CARDIOVASCULAR RISK; DISEASE SEVERITY; HEART DISEASE; HUMAN; HYPERTENSION; KIDNEY DISEASE; PRIORITY JOURNAL; PROGNOSIS; PROPHYLAXIS; REVIEW; VASCULAR DISEASE;

BLOOD PRESSURE; BLOOD PRESSURE DETERMINATION; BLOOD PRESSURE MONITORING, AMBULATORY; CARDIOVASCULAR DISEASES; DISEASE PROGRESSION; HUMANS; PROGNOSIS;

EID: 84885148721     PISSN: 08037051     EISSN: 16511999     Source Type: Journal    
DOI: 10.3109/08037051.2013.782944     Document Type: Review

References (96)

1. Joyce C, L evitan EB, H olt E, S himbo D, Webber LS, et al. Reproducibility of visit-to-visit variability of blood pressure measured as part of routine clinical care. J Hypertens. 2011; 29 : 2332-2338 .
2. Parati G, O choa JE, B ilo G. Blood Pressure Variability, cardiovascular risk, and risk for renal disease progression. Curr Hypertens Rep. 2012 .
3. Mancia G PG, di Rienzo M, Zanchetti A. Blood pressure variability. In: Mancia G ZA, editor. Handbook of hypertension: Pathophysiology of hypertension. Amsterdam: Elsevier Science; 1997. p. 117-169 .
4. B evan AT H A, S tott F H. P ortable recorder for continuous arterial pressure measurement in man. J Physiol. 1966; 38 : 186-190 .
5. Penaz J. [ Current photoelectric recording of blood flow through the fi nger]. Cesk Fysiol. 1975; 24 : 349-352. Prubezny fotoelektricky zaznam prutoku krve prstem .
6. Smith N T, W esseling K H, d e Wit B. Evaluation of two prototype devices producing noninvasive, pulsatile, calibrated blood pressure measurement from a fi nger. J Clin Monit. 1985; 1 : 17-29 . (Pubitemid 15239781)
7. Parati G, C asadei R, G roppelli A, D i Rienzo M, Mancia G. Comparison of fi nger and intra-arterial blood pressure monitoring at rest and during laboratory testing. Hypertension. 1989; 13(6 Pt 1) : 647-655 . (Pubitemid 19157951)
8. Parati G, S aul JP, D i Rienzo M, Mancia G. S pectral analysis of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal. Hypertension. 1995; 25 : 1276-1286 .
9. Mancia G, F errari A, G regorini L, P arati G, P omidossi G, Bertinieri G, et al. Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circ Res. 1983; 53 : 96-104 . (Pubitemid 13031772)
10. Parati G, P omidossi G, A lbini F, M alaspina D, Mancia G. Relationship of 24-hour blood pressure mean and variability to severity of target-organ damage in hypertension. J Hypertens. 1987; 5 : 93-98 . (Pubitemid 17058039)
11. Parati G, O mboni S, R izzoni D, A gabiti-Rosei E, Mancia G. The smoothness index: A new, reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension. J Hypertens. 1998; 16 : 1685-1691 . (Pubitemid 28515496)
12. Mancia G, D i Rienzo M, P arati G. A mbulatory blood pressure monitoring use in hypertension research and clinical practice. Hypertension. 1993; 21 : 510-524 . (Pubitemid 23095166)
13. Bilo G, G iglio A, S tyczkiewicz K, C aldara G, M aronati A, Kawecka-Jaszcz K, et al. A new method for assessing 24-h blood pressure variability after excluding the contribution of nocturnal blood pressure fall. J Hypertens. 2007; 25 : 2058-2066 . (Pubitemid 47476302)
14. Mancia G, B ombelli M, F acchetti R, M adotto F, C orrao G, Trevano FQ, et al. Long-term prognostic value of blood pressure variability in the general population: Results of the Pressioni Arteriose Monitorate e Loro Associazioni Study. Hypertension. 2007; 49 : 1265-1270 . (Pubitemid 46809367)
15. Mena L, P intos S, Q ueipo NV, A izpurua JA, M aestre G, Sulbaran T. A reliable index for the prognostic signifi cance of blood pressure variability. J Hypertens. 2005; 23 : 505-511 . (Pubitemid 40684707)
16. Stolarz-Skrzypek K, T hijs L, R ichart T, L i Y, H ansen TW, Boggia J, et al. Blood pressure variability in relation to outcome in the international database of ambulatory blood pressure in relation to cardiovascular outcome. Hypertens Res. 2010; 33 : 757-766 .
17. Rothwell P M, H oward S C, D olan E, O 'Brien E, D obson J E, Dahlof B, et al. Prognostic signifi cance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010; 375 : 895-905 .
18. Stergiou GS, N asothimiou EG. H ome monitoring is the optimal method for assessing blood pressure variability. Hypertens Res. 2011; 34 : 1246-1248 .
19. Mancia G, P arati G, P omidossi G, C asadei R, D i Rienzo M, Zanchetti A. Arterial barorefl exes and blood pressure and heart rate variabilities in humans. Hypertension. 1986; 8 : 147-153 . (Pubitemid 16105223)
20. Conway J, B oon N, D avies C, J ones JV, S leight P. N eural and humoral mechanisms involved in blood pressure variability. J Hypertens. 1984; 2 : 203-208 . (Pubitemid 14095784)
21. Parati G, F aini A, V alentini M. Blood pressure variability: Its measurement and signifi cance in hypertension. Curr Hypertens Rep. 2006; 8 : 199-204 . (Pubitemid 43853446)
22. Kotsis V, S tabouli S, K arafi llis I, P apakatsika S, R izos Z, Miyakis S, et al. Arterial stiffness and 24 h ambulatory blood pressure monitoring in young healthy volunteers: The early vascular ageing Aristotle University Thessaloniki Study (EVAARIS Study). Atherosclerosis. 2011; 219 : 194-199 .
23. Schillaci G, B ilo G, P ucci G, L aurent S, M acquin-Mavier I, Boutouyrie P, et al. Relationship between short-term blood pressure variability and large-artery stiffness in human hypertension: Findings from 2 large databases. Hypertension. 2012; 60 : 369-377 .
24. Parati G, C astiglioni P, D i Rienzo M, O mboni S, P edotti A, Mancia G. Sequential spectral analysis of 24-hour blood pressure and pulse interval in humans. Hypertension. 1990; 16 : 414-421 . (Pubitemid 20338535)
25. Pickering T G, H all JE, A ppel LJ, F alkner BE, G raves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: Blood pressure measurement in humans: A statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association CounciLon High Blood Pressure Research. Hypertension. 2005; 45 : 142-161 . (Pubitemid 40066429)
26. Narkiewicz K, W innicki M, Schroeder K, P hillips BG, Kato M, Cwalina E, et al. Relationship between muscle sympathetic nerve activity and diurnal blood pressure profi le. Hypertension. 2002; 39 : 168-172 . (Pubitemid 34098106)
27. Fujii T, U zu T, N ishimura M, T akeji M, K uroda S, Nakamura S, et al. Circadian rhythm of natriuresis is disturbed in nondipper type of essential hypertension. Am J Kidney Dis. 1999; 33 : 29-35 . (Pubitemid 29031205)
28. Verdecchia P, Schillaci G, G atteschi C, Zampi I, B attistelli M, Bartoccini C, et al. Blunted nocturnal fall in blood pressure in hypertensive women with future cardiovascular morbid events. Circulation. 1993; 88 : 986-992 . (Pubitemid 23264014)
29. Haynes WG. R ole of leptin in obesity-related hypertension. Exp Physiol. 2005; 90 : 683-688 . (Pubitemid 41406056)
30. Murakami S, O tsuka K, K ubo Y, S hinagawa M, M atsuoka O, Yamanaka T, et al. Weekly variation of home and ambulatory blood pressure and relation between arterial stiffness and blood pressure measurements in community-dwelling hypertensives. Clin Exp Hypertens. 2005; 27 : 231-239 . (Pubitemid 40478351)
31. Muntner P, S himbo D, T onelli M, R eynolds K, A rnett D K, Oparil S. The relationship between visit-to-visit variability in systolic blood pressure and all-cause mortality in the general population: Findings from NHANES III, 1988 to 1994. Hypertension. 2011; 57 : 160-166 .
32. Mancia G, M esserli F, B akris G, Z hou Q, C hampion A, Pepine CJ. Blood pressure control and improved cardiovascular outcomes in the International Verapamil SR-Trandolapril Study. Hypertension. 2007; 50 : 299-305 . (Pubitemid 47205777)
33. Parati G, B ilo G. C alcium antagonist added to angiotensin receptor blocker: A recipe for reducing blood pressure variability: Evidence from day-by-day home blood pressure monitoring. Hypertension. 2012; 59 : 1091-1093 .
34. Sega R, C esana G, B ombelli M, G rassi G, S tella ML, Zanchetti A, et al. Seasonal variations in home and ambulatory blood pressure in the PAMELA population. Pressione Arteriose Monitorate E Loro Associazioni. J Hypertens. 1998; 16 : 1585-1592 . (Pubitemid 28515484)
35. Modesti PA, M orabito M, B ertolozzi I, M assetti L, P anci G, Lumachi C, et al. Weather-related changes in 24-hour blood pressure profi le: Effects of age and implications for hypertension management. Hypertension. 2006; 47 : 155-161 . (Pubitemid 43189757)
36. Frattola A, P arati G, C uspidi C, A lbini F, Mancia G. Prognostic value of 24-hour blood pressure variability. J Hypertens. 1993; 11 : 1133-1137 . (Pubitemid 23307888)
37. Mancia G, P arati G, H ennig M, F latau B, O mboni S, Glavina F, et al. Relation between blood pressure variability and carotid artery damage in hypertension: Baseline data from the European Lacidipine Study on Atherosclerosis (ELSA). J Hypertens. 2001; 19 : 1981-1989 . (Pubitemid 33035803)
38. Mancia G, P arati G. The role of blood pressure variability in end-organ damage. J Hypertens Suppl. 2003; 21 : S17-S23 .
39. Sega R, C orrao G, B ombelli M, B eltrame L, F acchetti R, Grassi G, et al. Blood pressure variability and organ damage in a general population: Results from the PAMELA study (Pressioni Arteriose Monitorate E Loro Associazioni). Hypertension. 2002; 39(2 Pt 2) : 710-714. (Pubitemid 34165211)
40. Tatasciore A, R enda G, Z imarino M, S occio M, B ilo G, Parati G, et al. Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension. 2007; 50 : 325-332 . (Pubitemid 47205781)
41. Manios E, T sagalis G, T sivgoulis G, B arlas G, K oroboki E, Michas F, et al. Time rate of blood pressure variation is associated with impaired renal function in hypertensive patients. J Hypertens. 2009; 27 : 2244-2248 .
42. Sander D, K ukla C, K lingelhofer J, W inbeck K, C onrad B. Relationship between circadian blood pressure patterns and progression of early carotid atherosclerosis: A 3-year follow-up study. Circulation. 2000; 102 : 1536-1541 .
43. Dawson SL, M anktelow BN, R obinson TG, P anerai RB, Potter JF. Which parameters of beat-to-beat blood pressure and variability best predict early outcome after acute ischemic stroke Stroke. 2000; 31 : 463-468 . (Pubitemid 30078183)
44. Pringle E, P hillips C, T hijs L, D avidson C, S taessen JA, De Leeuw PW, et al. Systolic blood pressure variability as a risk factor for stroke and cardiovascular mortality in the elderly hypertensive population. J Hypertens. 2003; 21 : 2251-2257 . (Pubitemid 38293563)
45. Kario K, P ickering T G, U meda Y, H oshide S, H oshide Y, Morinari M, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: A prospective study. Circulation. 2003; 107 : 1401-1406 . (Pubitemid 36350739)
46. Kario K, I shikawa J, P ickering TG, H oshide S, E guchi K, Morinari M, et al. Morning hypertension: The strongest independent risk factor for stroke in elderly hypertensive patients. Hypertens Res. 2006; 29 : 581-587 . (Pubitemid 44430466)
47. Verdecchia P, A ngeli F, G attobigio R, R apicetta C, R eboldi G. Impact of blood pressure variability on cardiac and cerebrovascular complications in hypertension. American J Hypertens. 2007; 20 : 154-161 . (Pubitemid 46150022)
48. Hansen TW, T hijs L, L i Y, B oggia J, K ikuya M, Bjorklund-Bodegard K, et al. Prognostic value of readingto-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations. Hypertension. 2010; 55 : 1049-1057 .
49. Kikuya M, H ozawa A, O hokubo T, T suji I, M ichimata M, Matsubara M, et al. Prognostic signifi cance of blood pressure and heart rate variabilities: The Ohasama Study. Hypertension. 2000; 36 : 901-906 .
50. Staessen J A, T hijs L, F agard R, O 'Brien E T, C lement D, De Leeuw PW, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA. 1999; 282 : 539-546 . (Pubitemid 29380290)
51. Sega R, F acchetti R, B ombelli M, C esana G, C orrao G, Grassi G, et al. Prognostic value of ambulatory and home blood pressures compared with offi ce blood pressure in the general population: Follow-uPresults from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation. 2005; 111 : 1777-1183 .
52. Kikuya M, O hkubo T, A sayama K, M etoki H, O bara T, Saito S, et al. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: The Ohasama Study. Hypertension. 2005; 45 : 240-245 . (Pubitemid 40179967)
53. Fagard RH, C elis H, T hijs L, S taessen JA, C lement DL, De Buyzere ML, et al. Daytime and nighttime blood pressure as predictors of death and cause-specifi c cardiovascular events in hypertension. Hypertension. 2008; 51 : 55-61 . (Pubitemid 350307104)
54. Boggia J, L i Y, Thijs L, H ansen TW, K ikuya M, Bjorklund-Bodegard K, et al. Prognostic accuracy of day versus night ambulatory blood pressure: A cohort study. Lancet. 2007; 370 : 1219-1229 . (Pubitemid 47503300)
55. Hansen TW, L i Y, B oggia J, T hijs L, R ichart T, S taessen JA. Predictive role of the nighttime blood pressure. Hypertension. 2011; 57 : 3-10 .
56. Clement DL, D e Buyzere ML, D e Bacquer DA, De Leeuw PW, Duprez DA, Fagard RH, et al. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med. 2003; 348 : 2407-2415 . (Pubitemid 36682819)
57. Fagard RH, V an Den Broeke C, D e Cort P. Prognostic signifi cance of blood pressure measured in the offi ce, at home and during ambulatory monitoring in older patients in general practice. J Human Hypertens. 2005; 19 : 801-807 . (Pubitemid 41486143)
58. Redon J, C ampos C, N arciso ML, R odicio JL, P ascual JM, Ruilope LM. Prognostic value of ambulatory blood pressure monitoring in refractory hypertension: A prospective study. Hypertension. 1998; 31 : 712-718 .
59. Dolan E, S tanton A, T hijs L, H inedi K, A tkins N, M cClory S, et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: The Dublin outcome study. Hypertension. 2005; 46 : 156-161 . (Pubitemid 40946507)
60. Hansen TW, Jeppesen J, Rasmussen S, Ibsen H, Torp-Pedersen C. Ambulatory blood pressure and mortality: A population-based study. Hypertension. 2005; 45 : 499-504 . (Pubitemid 40411250)
61. Lurbe E, R edon J, K esani A, P ascual JM, T acons J, A lvarez V, et al. Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. N Engl J Med. 2002; 347 : 797-805 . (Pubitemid 34988338)
62. Metoki H, O hkubo T, K ikuya M, A sayama K, O bara T, Hashimoto J, et al. Prognostic signifi cance for stroke of a morning pressor surge and a nocturnal blood pressure decline: The Ohasama Study. Hypertension. 2006; 47 : 149-154 . (Pubitemid 43189756)
63. Matsui Y, I shikawa J, E guchi K, S hibasaki S, S himada K, Kario K. Maximum value of home blood pressure: A novel indicator of target organ damage in hypertension. Hypertension. 2011; 57 : 1087-1093 .
64. Kikuya M, O hkubo T, M etoki H, A sayama K, H ara A, Obara T, et al. Day-by-day variability of blood pressure and heart rate at home as a novel predictor of prognosis: The Ohasama Study. Hypertension. 2008; 52 : 1045-1050 .
65. Johansson JK, N iiranen TJ, P uukka PJ, J ula A M. Prognostic value of the variability in home-measured blood pressure and heart rate: The Finn-Home Study. Hypertension. 2012; 59 : 212-218 .
66. Masugata H, S enda S, M urao K, I nukai M, H osomi N, Iwado Y, et al. Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients. Hypertens Res. 2011; 34 : 846-850 .
67. Nagai M, H oshide S, I shikawa J, S himada K, K ario K. Visit-to-visit blood pressure variations: New independent determinants for carotid artery measures in the elderly at high risk of cardiovascular disease. J Am Soc Hypertens. 2011; 5 : 184-192 .
68. Kilpatrick E S, Rigby AS, A tkin S L. The role of blood pressure variability in the development of nephropathy in type 1 diabetes. Diabetes Care. 2010; 33 : 2442-2447 .
69. Kawai T, O hishi M, K amide K, O nishi M, T akeya Y, T atara Y, et al. The impact of visit-to-visit variability in blood pressure on renal function. Hypertens Res. 2012; 35 : 239-243 .
70. Brickman AM, R eitz C, L uchsinger JA, M anly JJ, Schupf N, Muraskin J, et al. Long-term blood pressure fl uctuation and cerebrovascular disease in an elderly cohort. Arch Neurol. 2010; 67 : 564-569 .
71. Diaz K M, V eerabhadrappa P, K ashem M A, F eairheller DL, Sturgeon KM, Williamson ST, et al. Relationship of visit-tovisit and ambulatory blood pressure variability to vascular function in African Americans. Hypertens Res. 2012; 35 : 55-61 .
72. Hata Y, K imura Y, M uratani H, F ukiyama K, K awano Y, Ashida T, et al. Offi ce blood pressure variability as a predictor of brain infarction in elderly hypertensive patients. Hypertens Res. 2000; 23 : 553-560 . (Pubitemid 32040795)
73. Hata Y, M uratani H, K imura Y, F ukiyama K, K awano Y, Ashida T, et al. Offi ce blood pressure variability as a predictor of acute myocardial infarction in elderly patients receiving antihypertensive therapy. J Human Hypertens. 2002; 16 : 141-146. (Pubitemid 34182924)
74. Liu JG, Xu LP 74., C hu ZX, M iao CY, S u DF. Contribution of blood pressure variability to the effect of nitrendipine on end-organ damage in spontaneously hypertensive rats. J Hypertens. 2003; 21 : 1961-1967 .
75. Xie HH, M iao CY, J iang Y Y, S u DF. S ynergism of atenolol and nitrendipine on hemodynamic amelioration and organ protection in hypertensive rats. J Hypertens. 2005; 23 : 193-201 .
76. Xie HH, S hen FM, X u LP, H an P, M iao CY, S u DF. Reduction of blood pressure variability by combination therapy in spontaneously hypertensive rats. J Hypertens. 2007; 25 : 2334-2344 . (Pubitemid 47537929)
77. Han P, S hen F M, X ie H H, Chen Y Y, M iao C Y, M ehta J L, et al. The combination of atenolol and amlodipine is better than their monotherapy for preventing end-organ damage in different types of hypertension in rats. J Cell Mol Med. 2009; 13 : 726-734 .
78. Ling G, L iu AJ, S hen FM, C ai GJ, L iu JG, S u DF. Effects of combination therapy with atenolol and amlodipine on blood pressure control and stroke prevention in stroke-prone spontaneously hypertensive rats. Acta Pharmacol Sin. 2007; 28 : 1755-1760 . (Pubitemid 350029319)
79. Parati G, M utti E, F rattola A, C astiglioni P, d i Rienzo M, Mancia G. Beta-adrenergic blocking treatment and 24-hour barorefl ex sensitivity in essential hypertensive patients. Hypertension. 1994; 23(6 Pt 2) : 992-996 . (Pubitemid 24180852)
80. Cowley A W, Jr., L iard JF, G uyton A C. R ole of baroreceptor refl ex in daily control of arterial blood pressure and other variables in dogs. Circ Res. 1973; 32 : 564-576 .
81. Frattola A, Parati G, Castiglioni P, Paleari F, Ulian L, Rovaris G, et al. Lacidipine and blood pressure variability in diabetic hypertensive patients. Hypertension. 2000; 36 : 622-628 .
82. Ferrari A, B uccino N, D i Rienzo M, P edotti A, Mancia G, Zanchetti A. Labetalol and 24-hour monitoring of arterial blood pressure in hypertensive patients. J Cardiovasc Pharmacol. 1981; 3 Suppl 1 : S42-S52 .
83. Mancia G, F errari A, G regorini L, P arati G, P omidossi G, Grassi G, et al. Evaluation of a slow-release clonidine preparation by direct continuous blood pressure recording in essential hypertensive patients. J Cardiovasc Pharmacol. 1981; 3 : 1193-1202 . (Pubitemid 12235103)
84. Mancia G, F errari A, P omidossi G, P arati G, B ertinieri G, Grassi G, et al. Twenty-four-hour blood pressure profi le and blood pressure variability in untreated hypertension and during antihypertensive treatment by once-a-day nadolol. Am Heart J. 1984; 108(4 Pt 2) : 1078-1083 . (Pubitemid 15203374)
85. Pomidossi G, P arati G, M otolese M, Mancia G, Z anchetti A. Hemodynamic effects of once a day administration of combined chlorthalidone and metoprolol slow-release in essential hypertension. Int J Clin Pharmacol Ther Toxicol. 1984; 22 : 665-671 . (Pubitemid 15213821)
86. Pomidossi G, P arati G, M alaspina D, C amesasca C, Motolese M, Zanchetti A, et al. Antihypertensive effect of a new formulation of slow release oxprenolol in essential hypertension. J Cardiovasc Pharmacol. 1987; 10 : 593-598 . (Pubitemid 18008817)
87. Parati G, P omidossi G, C asadei R, R avogli A, T razzi S, Mutti E, et al. 24-h ambulatory non-invasive blood pressure monitoring in the assessment of the antihypertensive action of celiprolol. J Int Med Res. 1988; 16 Suppl 1 : 52A-61A .
88. Mancia G, D e Cesaris R, F ogari R, L attuada S, Montemurro G, Palombo C, et al. Evaluation of the antihypertensive effect of once-a-day trandolapril by 24-hour ambulatory blood pressure monitoring. The Italian Trandolapril Study Group. Am J Cardiol. 1992; 70 : 60D-66D .
89. Mancia G, O mboni S, R avogli A, P arati G, Z anchetti A. Ambulatory blood pressure monitoring in the evaluation of antihypertensive treatment: Additional information from a large data base. Blood Press. 1995; 4 : 148-156 .
90. Collins R, P eto R, M acMahon S, H ebert P, F iebach NH, Eberlein KA, et al. Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: Overview of randomised drug trials in their epidemiological context. Lancet. 1990; 335 : 827-838 . (Pubitemid 20113741)
91. Turnbull F. Effects of different blood-pressure-lowering regimens on major cardiovascular events: Results of prospectively-designed overviews of randomised trials. Lancet. 2003; 362 : 1527-1535 . (Pubitemid 37410190)
92. Webb A J, F ischer U, M ehta Z, R othwell PM. Effects of antihypertensive-drug class on interindividual variation in blood pressure and risk of stroke: A systematic review and metaanalysis. Lancet. 2010; 375 : 906-915 .
93. Rothwell P M, H oward S C, D olan E, O 'Brien E, D obson J E, Dahlof B, et al. Effects of beta blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke. Lancet Neurol. 2010; 9 : 469-480 .
94. R othwell PM. L imitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet. 2010; 375 : 938-948 .
95. Mancia G, F acchetti R, P arati G, Z anchetti A. V isit-to-visit blood pressure variability in the European Lacidipine Study on Atherosclerosis: Methodological aspects and effects of antihypertensive treatment. J Hypertens. 2012; 30 : 1241-1251 .
96. di Rienzo M, G rassi G, P edotti A, Mancia G. Continuous vs intermittent blood pressure measurements in estimating 24-hour average blood pressure. Hypertension. 1983; 5 : 264-269 . (Pubitemid 13164355)