Short-term blood pressure variability as a potential therapeutic target for kidney disease

Clinical Hypertension

Review

Ye Eun Ko¹  Jong Hyun Jhee² 

[1]Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

[2]Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

关键词: Blood pressure;    Ambulatory blood pressure monitoring;    Hypertension;    Chronic renal insufficiency;   

DOI  :  10.1186/s40885-023-00248-3

 received in 2023-02-26, accepted in 2023-07-11,  发布年份 2023

来源: Springer

【 摘 要 】

Short-term blood pressure variability (BPV) measured with ambulatory blood pressure (BP) monitoring has been demonstrated to be significant in predicting various clinical outcomes. Short-term BPV is distinguished from long-term BPV based on the time interval in which BP fluctuations are measured. Increased short-term BPV has been linked to detrimental effects on the microvascular structure and contributes to subclinical organ damage in the heart, blood vessels, and kidneys, regardless of the average 24-h BP levels. Short-term BPV can be defined by various measures, including calculated metrics (standard deviation, coefficient of variation, average real variability, weighted standard deviation, variability independent of the mean) or dipping patterns. Nevertheless, the additional role of short-term BPV beyond the predictive value of average 24-h BPs or established risk factors for cardiovascular disease and kidney disease remains unclear. In particular, longitudinal studies that evaluate the association between short-term BPV and kidney function impairment are limited and no conclusive data exist regarding which short-term BPV indicators most accurately reflect the prognosis of kidney disease. The issue of how to treat BPV in clinical practice is another concern that is frequently raised. This paper presents a review of the evidence for the prognostic role of short-term BPV in kidney outcomes. Additionally, this review discusses the remaining concerns about short-term BPV that need to be further investigated as an independent risk modifier.

【 授权许可】

CC BY   
© The Author(s) 2023