Does blood pressure variability affect hypertension development in pre-hypertensive patients?

Background Blood pressure variability (BPV) is associated with end organ damage and cardiovascular outcomes in hypertensive patients. Pre-hypertensive patients frequently develop hypertension (HT). The purpose of the present study was to evaluate the effect of BPV on the development of HT. Methods Two hundred seven pre-hypertensive patients from the Cappadocia cohort were monitored over two years, and 24-h ambulatory blood pressure monitoring (24-h ABPM), office and home BP measurements were subsequently performed at four to six-month intervals. BPV was calculated as average real variability (ARV) from 24-h ABPM data, home and office BP measurements at first visit. The relationship was evaluated between baseline ARV and the development of HT. Results HT was diagnosed in 25.60% of subjects. Baseline 24-h ABPM systolic blood pressure (SBP)ARV and diastolic blood pressure (DBP)ARV and home SBP ARV were significantly higher in patients who developed HT than the other patients (p 0.006, 0.001 and 0.006, respectively). Baseline 24h-ABPM SBPARV and home SBPARV exceeding the 90 th percentile were identified as parameters affecting development of HT at logistic regression analysis. Conclusion In conclusion, our prospective observational cohort study showed that short-term BPV in particular can predict the development of HT in the pre-hypertensive population.