The next big thing: A case report on Blood Pressure Variation encountered in my clinic

The role of high Blood Pressure levels on target organ damage and the protective effects of antihypertensive therapy have been extensively established in clinical practice [1]. Mortality from ischemic heart disease and stroke doubles every increment in 20 and 10 mmHg of systolic and diastolic blood pressure [1]. Nowadays, besides usual blood pressure other parameters contribute to TOD in hypertensive patients [2]. Blood pressure is a constant variable and it shows marked spontaneous oscillations over short-term (minutes to days) and long-term (month) periods [3]. Early reports from animal models of cardiovascular variability have clearly demonstrated the relationship between excessive fluctuation in blood pressure values and the development of target organ damage [4]. The initial hypothesis was further corroborated by clinical studies in hypertensive subjects showing that the assessment and quantification of Blood Pressure Variability (BPV) is of physio-pathological and prognostic importance [5]. In recent years, many preclinical and clinical studies have clearly identified the contribution of BPV to the cardiovascular complications associated with hypertension [6]. Moreover, preliminary data from retrospective analysis of clinical trials suggest that attenuation of BPV by antihypertensive agents contribute in the prevention of major cardiovascular events in hypertensive patients [7]. Considering the recent advances in the knowledge of the pathological role and clinical significance of BPV in cardiovascular diseases, the present case illustrates the Blood Pressure Variation in a routine OPD setting.