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(Hypertension. 2008;52:1006.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Clinical Relevance of Day-by-Day Blood Pressure and Heart Rate Variability

New Information From Home Self-Measurements

Gianfranco Parati; Grzegorz Bilo

From the Department of Clinical Medicine and Prevention, University of Milano-Bicocca; and the Department of Cardiology, S Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy.

Correspondence to Gianfranco Parati, Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, via Spagnoletto 3, 20149 Milan, Italy. E-mail gianfranco.parati@unimib.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Both in normotensive and in hypertensive subjects, blood pressure (BP) is characterized by continuous fluctuations in relation to the different daytime and nighttime activities.¹ Studies based on ambulatory BP monitoring (ABPM) have provided evidence that BP and heart rate (HR) variability (V) over 24 hours carry important pathophysiological information and have clinical relevance both in the diagnostic and prognostic assessments of hypertension. Different BPV and HRV patterns reflect specific features of autonomic cardiovascular regulation, and the magnitude of BP swings over the day and night has been shown to be associated with severity of organ damage and rate of cardiovascular events.^2–5 As a consequence, it has been suggested recently that the benefits of hypertension treatment, in terms of organ damage prevention or regression and in terms of event rate reduction, might be greater by targeting not only mean BP level reduction but also the attenuation of the deranged BP variability found frequently in hypertensive patients.⁶

Traditional office BP measurements are unable to account for daily life BPV and HRV,¹ which explains the growing interest toward out-of-office BP measurements, either through ABPM or, in more recent times, through home (H)BPM. In spite of its relevant advantages, however, routine use of ABPM has found only limited applicability in clinical practice up to now, partly because of its inconvenience in active patients and because of its impact on health care costs. Use of HBPM in the diagnosis and management of arterial hypertension, however, is continuously increasing, its rapid diffusion being favored by technological . . . [Full Text of this Article]

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Hypertension 2008 52: 1045-1050. [Abstract] [Full Text] [PDF]

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				G. Parati, S. Omboni, and G. Bilo Why Is Out-of-Office Blood Pressure Measurement Needed?: Home Blood Pressure Measurements Will Increasingly Replace Ambulatory Blood Pressure Monitoring in the Diagnosis and Management of Hypertension Hypertension, August 1, 2009; 54(2): 181 - 187. [Full Text] [PDF]