Las posibles limitaciones de nuestro trabajo son, en primer lugar, su diseño transversal nos impide establecer relaciones de causalidad entre los diferentes parámetros analizados en los estudios realizados.
La segunda limitación es la selección de la población de estudio, los pacientes se incluyeron mediante muestreo consecutivo con criterios de inclusión amplios. Por lo tanto, la población de estudio incluye a pacientes hipertensos con diagnóstico reciente de hipertensión arterial, algunos sujetos con diabetes e hiperlipidemia, y muchos pacientes que recibían terapia con medicamentos. Estas circunstancias pueden modificar los valores de presión arterial y, por lo tanto, pueden limitar la validez de algunos resultados. Sin embargo, los resultados, en la mayoría de los estudios realizados, no cambian después de ajustar por estas variables en el análisis multivariante. Por consiguiente, la heterogeneidad de la muestra podría dar lugar a algunas limitaciones en la interpretación de los resultados, aunque la muestra es bastante similar a la distribución de los pacientes hipertensos en la población general, con algún factor de riesgo, que acuden a los consultas de Atención Primaria. Por lo tanto, creemos que representa a la población general consultante en centros de atención primaria de salud.
Por último, las mediciones ambulatorias de la presión arterial limita el cálculo en los intervalos de tiempo cortos; este cálculo requiere un método invasivo capaz de detectar los cambios latido a latido porque las mediciones a intervalos mayores de cinco minutos puede crear errores de ± 10% [302].
1. El aumento del índice de rigidez arterial ambulatoria se asocia con mayor presencia de lesión orgánica vascular, cardiaca y renal en pacientes con hipertensión arterial independientemente de que tomen o no fármacos antihipertensivos.
2. Tanto la frecuencia cardiaca clínica como la ambulatoria y sus correspondientes desviaciones estándar, presentan asociación inversa con los marcadores de la rigidez arterial, excepto con la velocidad de onda de pulso, que presenta asociación directa.
3. La frecuencia cardiaca ambulatoria elevada y su variabilidad, pero no la clínica, se asociaron con una disminución del grosor íntima-media de la arteria carótida y con una mayor tasa de filtrado glomerular. Sin embargo, esta asociación desaparee al ajustarlo por edad.
4. La variabilidad de la presión arterial en pacientes hipertensos, analizada tanto con la desviación estándar como con el coeficiente de variación, se asocia con la rigidez arterial evaluada con la velocidad de la onda de pulso. La monitorización ambulatoria de la presión arterial es más accesible en la clínica que la determinación de la velocidad de la onda del pulso, por lo tanto, la evaluación de la variabilidad de la presión arterial (24 horas, día y noche) pueden ser útiles para la evaluación de la rigidez arterial.
1.-Bonow OR, Mann LD, Zipes PD, Libby P. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Braunwald E, editor. Philadelphia: Elsevier
Saunders; 2012.
2.-Kotchen TA. Historical trends and milestones in hypertension research: a model of the process of translational research. Hypertension. 2011;58:522-38.
3.-Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371:1513-8.
4.-Catala-Lopez F, Sanfelix-Gimeno G, Garcia-Torres C, Ridao M, Peiro S. Control of arterial hypertension in Spain: a systematic review and meta-analysis of 76 epidemiological studies on 341 632 participants. J Hypertens. 2012;30:168-76.
5.-INSTITUTO NACIONAL DE ESTADÍSTICA. Defunciones según la causa de muerte. Año 2009. Notas de prensa. 2011.
6.-Lawes CM, Vander Hoorn S, Law MR, Elliott P, MacMahon S, Rodgers A. Blood pressure and the global burden of disease 2000. Part II: estimates of attributable burden. J Hypertens. 2006;24:423-30.
7.-Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.
8.-Ezzati M, Hoorn SV, Rodgers A, Lopez AD, Mathers CD, Murray CJ. Estimates of global and regional potential health gains from reducing multiple major risk factors. Lancet. 2003;362:271-80.
9.-World Health Organization. The World Health Report, 2002: reducing risks, promoting healthy life. Geneva: World Health Organization 2002.
10.-World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization
2009.
11.-National Clinical Guideline Centre (UK). Hypertension: The Clinical Management of Primary Hypertension in Adults: Update of Clinical Guidelines 18 and 34 [Internet] London: Royal College of Physicians (UK). 2011:(NICE Clinical Guidelines,
No. 127.) Available from: http://www.ncbi.nlm.nih.gov/books/NBK83274/.
12.-Listerri JL, Rodríguez GC, Alonso FJ, Barrios A, Banegas JR, gonzález-Segura D, al. e. Evolución del control de la presión arterial en España en el periodo 2002- 2006. Estudios PRESCAP. Hipertens riesgo vasc. 2009;26:257-65.
13.-Listerri JL, Rodríguez GC, Alonso FJ, Lou S, J.A. D, Santos JA, al. e. Control de la presión arterial en la población hipertensa española atendida en Atención Primaria. Estudio PRESCAP 2002. Med Clin (Barc). 2004;122:167-71.
14.-Coca A. Evolución del control de la hipertensión arterial en Atención Primaria en España. Resultados del estudio CONTROLPRES 2003. Hipertensión. 2005;22:5-
14.
15.-Álvarez-Sala LA, Suárez C, Mantilla T, Franch J, Ruilope LM, Banegas J, al. e.
Estudio PREVENCAT: control del riesgo cardiovascular en Atención Primaria.
Med Clin (Barc). 2005;125:406-10.
16.-Kaplan NM, Ronald G. Victor MD. Kaplan's Clinical Hypertension. 10th ed.
Kaplan's, editor. Philadelphia: Wollters Kluwer Health/Lippincott Williams & Wilkins; 2010.
17.-Kannel WB. Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertens. 2000;13:3S-10S.
18.-Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, Bertomeu V, Clement D, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O'Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Waeber B, Williams B. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J
Hypertens. 2007;25:1105-87.
19.-Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr., Jones DW, Materson BJ, Oparil S, Wright JT, Jr., Roccella EJ. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72.
20.-Kneisley J, Schork N, Julius S. Predictors of blood pressure and hypertension in Tecumseh, Michigan. Clin Exp Hypertens A. 1990;12:693-708.
21.-Woynarowska B, Mukherjee D, Roche AF, Siervogel RM. Blood pressure changes during adolescence and subsequent adult blood pressure level.
Hypertension. 1985;7:695-701.
22.-Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903-13.
23.-Atilla K, Vasan RS. Prehypertension and risk of cardiovascular disease. Expert
Rev Cardiovasc Ther. 2006;4:111-7.
24.-Joint effects of systolic blood pressure and serum cholesterol on cardiovascular disease in the Asia Pacific region. Circulation. 2005;112:3384-90.
25.-Banegas J, Segura J. Presión arterial y medida del riesgo cardiovascular.
Hipertensión. 2007;24:2-6.
26.-Medrano MJ, Cerrato E, Boix R, Delgado-Rodriguez M. Factores de riesgo cardiovascular en la población española: metaanálisis de estudios transversales. Med Clin (Barc). 2005;124:606-12.
27.-Felip A, Poch E, Davins J, Coca A. Perfil de riesgo cardiovascular de los pacientes atendidos en las Unidades de Hipertensión españolas. Resultados del estudio QUALIHTA. Hipertensión. 2007;24:4-10.
28.-Barrios V, Campuzano R, Peña G, Guzmán C, Ruilope LM. Estratificación del riesgo cardiovascular en Atención Primaria e impacto sobre el tratamiento antihipertensivo. Estudio DIORISC. Hipertensión. 2002;19:114-20.
29.-Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith Jr SC, Spertus JA, Costa F. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. Cardiol Rev. 2005;13:322-7.
30.-Cordero A, Alegría E, León M. Prevalencia de síndrome metabólico. Rev Esp
Cardiol. 2005;5:11-5.
31.-Cordero A, Moreno A, Alegría E. Hipertensión arterial y síndrome metabólico.
32.-Villar Álvarez F, Banegas Banegas JR, Donado Campos J, Rodríguez Artalejo F.
Las enfermedades cardiovasculares y sus factores de riesgo en España: hechos y cifras. Sociedad Española de Arteriosclerosis 2007.
33.-Benitez Camps M, Perez Zamora S, Dalfo Baque A, Piqueras Garre MM, Losada Doval G, Vila Coll MA. Estudio DISEHTAC II: diagnóstico y seguimiento de la hipertensión en Cataluña. Comparación con los datos de 1996. Aten Primaria.
2005;35:7-12.
34.-Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, Jones DW, Kurtz T, Sheps SG, Roccella EJ. 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 Council on High Blood Pressure Research. Hypertension. 2005;45:142-61.
35.-O'Brien E, Asmar R, Beilin L, Imai Y, Mallion JM, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, Pickering T, Redon J, Staessen J, Stergiou G, Verdecchia P. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens.
2003;21:821-48.
36.-Pickering TG. The influence of daily activity on ambulatory blood pressure.
Am Heart J. 1988;116:1141-5.
37.-Pickering TG, Gerin W, Schwartz JE, Spruill TM, Davidson KW. Franz Volhard lecture: should doctors still measure blood pressure? The missing patients with masked hypertension. J Hypertens. 2008;26:2259-67.
38.-Hodgkinson J, Mant J, Martin U, Guo B, Hobbs FD, Deeks JJ, Heneghan C, Roberts N, McManus RJ. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. BMJ. 2011;342:d3621.
39.-Dieterle T. Blood pressure measurement--an overview. Swiss Med Wkly.
2012;142:w13517.
40.-Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart
Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1-9.
41.-Coca A, Bertomeu V, Dalfo A, Esmatjes E, Guillen F, Guerrero L, Llisterri JL, Marin-Iranzo R, Megia C, Rodriguez-Manas L, Suarez C. [Blood pressure self measurement: Spanish consensus document]. Nefrologia. 2007;27:139-53.
42.-Denolle T. [Comparison and reproducibility of 4 methods of indirect blood pressure measurement in moderate hypertension]. Arch Mal Coeur Vaiss.
1995;88:1165-70.
43.-Rothwell PM. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet.
2010;375:938-48.
44.-Rothwell PM, Howard SC, Dolan E, O'Brien E, Dobson JE, Dahlof B, Sever PS, Poulter NR. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375:895-905.
45.-Pickering TG, Shimbo D, Haas D. Ambulatory blood-pressure monitoring. N
Engl J Med. 2006;354:2368-74.
46.-Hansen TW, Thijs L, Li Y, Boggia J, Kikuya M, Bjorklund-Bodegard K, Richart T, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Imai Y, Wang J, Ibsen H, O'Brien E, Staessen JA. Prognostic value of reading-to- reading blood pressure variability over 24 hours in 8938 subjects from 11 populations. Hypertension. 2010;55:1049-57.
47.-Parati G, Valentini M. Prognostic relevance of blood pressure variability.
Hypertension. 2006;47:137-8.
48.-Verdecchia P, Angeli F, Gattobigio R, Rapicetta C, Reboldi G. Impact of blood pressure variability on cardiac and cerebrovascular complications in hypertension. Am J Hypertens. 2007;20:154-61.
49.-Parati G. Blood pressure variability: its measurement and significance in hypertension. J Hypertens Suppl. 2005;23:S19-25.
50.-Mancia G, Bombelli M, Facchetti R, Madotto F, Corrao G, Trevano FQ, Grassi G, Sega R. Long-term prognostic value of blood pressure variability in the general population: results of the Pressioni Arteriose Monitorate e Loro Associazioni Study. Hypertension. 2007;49:1265-70.
51.-O'Brien E, Asmar R, Beilin L, Imai Y, Mancia G, Mengden T, Myers M, Padfield P, Palatini P, Parati G, Pickering T, Redon J, Staessen J, Stergiou G, Verdecchia P.
Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens. 2005;23:697-701.
52.-Kikuya M, Hansen TW, Thijs L, Bjorklund-Bodegard K, Kuznetsova T, Ohkubo T, Richart T, Torp-Pedersen C, Lind L, Ibsen H, Imai Y, Staessen JA. Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk. Circulation. 2007;115:2145-52.
53.-Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, Kario K, Lurbe E, Manolis A, Mengden T, O'Brien E, Ohkubo T, Padfield P, Palatini P, Pickering TG, Redon J, Revera M, Ruilope LM, Shennan A, Staessen JA, Tisler A, Waeber B, Zanchetti A, Mancia G. European Society of Hypertension practice guidelines for home blood pressure monitoring. J Hum Hypertens. 2010;24:779-85.
54.-Guidelines for the clinical use of 24 hour ambulatory blood pressure monitoring (ABPM) (JCS 2010): - digest version. Circ J. 2012;76:508-19.
55.-Dolan E, Stanton A, Thijs L, Hinedi K, Atkins N, McClory S, Den Hond E, McCormack P, Staessen JA, O'Brien E. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study.
Hypertension. 2005;46:156-61.
56.-O'Brien E. Twenty-four-hour ambulatory blood pressure measurement in clinical practice and research: a critical review of a technique in need of implementation. J Intern Med. 2011;269:478-95.
57.-Sierra C, de la Sierra A, Sobrino J, Segura J, Banegas JR, Gorostidi M, Ruilope LM. En representación de los Investigadores del Registro Nacional de MAPA. Sociedad Española de Hipertensión-Liga Española para la lucha contra la Hipertensión Arterial (SEH-LELHA). Monitorización ambulatoria de la presión arterial (MAPA): características clínicas de 31.530 pacientes. Med Clin (Barc).
2007;129:1-5.
58.-Gómez Marcos MA, García Ortiz L, Sánchez Rodríguez A, Parra Sánchez J, García García A, González Elena LJ. Control de la presión arterial, concordancias y discrepancias entre diferentes métodos de medida utilizados. Hipertensión.
59.-Ohkubo T, Kikuya M, Metoki H, Asayama K, Obara T, Hashimoto J, Totsune K, Hoshi H, Satoh H, Imai Y. Prognosis of "masked" hypertension and "white-coat" hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. J Am Coll Cardiol. 2005;46:508-15.
60.-Pierdomenico SD, Lapenna D, Bucci A, Di Tommaso R, Di Mascio R, Manente BM, Caldarella MP, Neri M, Cuccurullo F, Mezzetti A. Cardiovascular outcome in treated hypertensive patients with responder, masked, false resistant, and true resistant hypertension. Am J Hypertens. 2005;18:1422-8.
61.-Sega R, Facchetti R, Bombelli M, Cesana G, Corrao G, Grassi G, Mancia G.
Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Circulation.
2005;111:1777-83.
62.-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.
63.-Kikuya M, Ohkubo T, Asayama K, Metoki H, Obara T, Saito S, Hashimoto J, Totsune K, Hoshi H, Satoh H, Imai Y. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: the Ohasama study.
Hypertension. 2005;45:240-5.
64.-Vasunta RL, Kesaniemi YA, Ylitalo A, Ukkola O. Nondipping pattern and carotid atherosclerosis in a middle-aged population: OPERA Study. Am J Hypertens.
2012;25:60-6.
65.-Fan HQ, Li Y, Thijs L, Hansen TW, Boggia J, Kikuya M, Bjorklund-Bodegard K, Richart T, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz- Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Imai Y, Ibsen H, O'Brien E, Wang J, Staessen JA. Prognostic value of isolated nocturnal hypertension on ambulatory measurement in 8711 individuals from 10 populations. J Hypertens. 2010;28:2036-45.
66.-Logan AG. Ambulatory blood pressure monitoring: its time to move on! J
Hypertens. 2010;28:2000-2.
67.-Kanbay M, Turgut F, Uyar ME, Akcay A, Covic A. Causes and mechanisms of nondipping hypertension. Clin Exp Hypertens. 2008;30:585-97.
68.-Gorostidi M, Sobrino J, Segura J, Sierra C, de la Sierra A, Hernandez del Rey R, Vinyoles E, Galceran JM, Lopez-Eady MD, Marin R, Banegas JR, Sarria A, Coca A, Ruilope LM. Ambulatory blood pressure monitoring in hypertensive patients with high cardiovascular risk: a cross-sectional analysis of a 20,000-patient database in Spain. J Hypertens. 2007;25:977-84.
69.-Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives.
Hypertension. 2001;38:852-7.
70.-Hermida RC, Calvo C, Ayala DE, Lopez JE. Relationship between physical activity and blood pressure in dipper and non-dipper hypertensive patients. J
Hypertens. 2002;20:1097-104.
71.-Cuspidi C, Meani S, Salerno M, Valerio C, Fusi V, Severgnini B, Lonati L, Magrini F, Zanchetti A. Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure. J Hypertens.
2004;22:273-80.
72.-Routledge FS, McFetridge-Durdle JA, Dean CR. Night-time blood pressure patterns and target organ damage: a review. Can J Cardiol. 2007;23:132-8.
73.-Davidson MB, Hix JK, Vidt DG, Brotman DJ. Association of impaired diurnal blood pressure variation with a subsequent decline in glomerular filtration rate.
Arch Intern Med. 2006;166:846-52.
74.-Verdecchia P, Porcellati C, Schillaci G, Borgioni C, Ciucci A, Battistelli M, Guerrieri M, Gatteschi C, Zampi I, Santucci A, et al. Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. Hypertension.
1994;24:793-801.
75.-Staessen JA, Thijs L, Fagard R, O'Brien ET, Clement D, de Leeuw PW, Mancia G, Nachev C, Palatini P, Parati G, Tuomilehto J, Webster J. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA.
1999;282:539-46.
76.-Metoki H, Ohkubo T, Kikuya M, Asayama K, Obara T, Hashimoto J, al. e.
Prognostic significance for stroke of a morning pressor surge and a nocturnal blood pressure decline. The Ohasama Study. Hypertension. 2006;47:149-54.
77.-Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183-
9.
78.-Fagard RH, Celis H. Prognostic significance of various characteristics of out- of-the-office blood pressure. J Hypertens. 2004;22:1663-6.
79.-Holl RW, Pavlovic M, Heinze E, Thon A. Circadian blood pressure during the early course of type 1 diabetes. Analysis of 1,011 ambulatory blood pressure recordings in 354 adolescents and young adults. Diabetes Care. 1999;22:1151-7.
80.-Lurbe E, Redon J, Pascual JM, Tacons J, Alvarez V. The spectrum of circadian blood pressure changes in type I diabetic patients. J Hypertens. 2001;19:1421-8.
81.-Peixoto AJ, White WB. Circadian blood pressure: clinical implications based on the pathophysiology of its variability. Kidney Int. 2007;71:855-60.
82.-Spallone V, Maiello MR, Cicconetti E, Pannone A, Barini A, Gambardella S, Menzinger G. Factors determining the 24-h blood pressure profile in normotensive patients with type 1 and type 2 diabetes. J Hum Hypertens.
2001;15:239-46.
83.-Mediavilla García JD, Fernández Torres C, López de la torre M, Aliaga Martínez L, Jiménez Alonso J. Monitorización ambulatoria de la presión arterial y enfermedad renal crónica en pacientes hipertensos diabéticos tipo 2 y en pacientes hipertensos. Hipertensión. 2008;25.
84.-SEH-LELHA. Guía Española de Hipertensión Arterial 2005. Hipertensión.
2005;22:16-26.
85.-Vinyoles E. Presión ambulatoria y enfermedad cardiovascular. Hipertensión.
2008;25:35-43.
86.-Verdecchia P, Borgioni C, Ciucci A, Gattobigio R, Schillaci G, Sacchi N, Santucci A, Santucci C, Reboldi G, Porcellati C. Prognostic significance of blood pressure variability in essential hypertension. Blood Press Monit. 1996;1:3-11.
87.-Tatasciore A, Renda G, Zimarino M, Soccio M, Bilo G, Parati G, Schillaci G, De Caterina R. Awake systolic blood pressure variability correlates with target-organ damage in hypertensive subjects. Hypertension. 2007;50:325-32.
88.-Garcia-Ortiz L, Gomez-Marcos MA, Martin-Moreiras J, Gonzalez-Elena LJ, Recio- Rodriguez JI, Castano-Sanchez Y, Grandes G, Martinez-Salgado C. Pulse pressure and nocturnal fall in blood pressure are predictors of vascular, cardiac and renal target organ damage in hypertensive patients (LOD-RISK study). Blood Press
Monit. 2009;14:145-51.
89.-Musini VM, Wright JM. Factors affecting blood pressure variability: lessons learned from two systematic reviews of randomized controlled trials. PLoS One.
2009;4:e5673.
90.-Parati G, Rizzoni D. Assessing the prognostic relevance of blood pressure variability: discrepant information from different indices. J Hypertens.
2005;23:483-6.
91.-Pringle E, Phillips C, Thijs L, Davidson C, Staessen JA, de Leeuw PW, Jaaskivi M, Nachev C, Parati G, O'Brien ET, Tuomilehto J, Webster J, Bulpitt CJ, Fagard RH.
Systolic blood pressure variability as a risk factor for stroke and cardiovascular mortality in the elderly hypertensive population. J Hypertens. 2003;21:2251-7.
92.-Sega R, Trocino G, Lanzarotti A, Carugo S, Cesana G, Schiavina R, Valagussa F, Bombelli M, Giannattasio C, Zanchetti A, Mancia G. Alterations of cardiac structure in patients with isolated office, ambulatory, or home hypertension: Data from the general population (Pressione Arteriose Monitorate E Loro Associazioni [PAMELA] Study). Circulation. 2001;104:1385-92.
93.-Zakopoulos NA, Tsivgoulis G, Barlas G, Papamichael C, Spengos K, Manios E, Ikonomidis I, Kotsis V, Spiliopoulou I, Vemmos K, Mavrikakis M, Moulopoulos SD.
Time rate of blood pressure variation is associated with increased common carotid artery íntima-media thickness. Hypertension. 2005;45:505-12.
94.-Hsieh YT, Tu ST, Cho TJ, Chang SJ, Chen JF, Hsieh MC. Visit-to-visit variability in blood pressure strongly predicts all-cause mortality in patients with type 2 diabetes: a 5.5-year prospective analysis. Eur J Clin Invest. 2012;42:245-53.
95.-Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H. Expert consensus document on arterial stiffness: methodological issues and clinical applications.
Eur Heart J. 2006;27:2588-605.
96.-Kotsis V, Stabouli S, Karafillis I, Papakatsika S, Rizos Z, Miyakis S, Goulopoulou S, Parati G, Nilsson P. Arterial stiffness and 24 h ambulatory blood pressure
monitoring in young healthy volunteers: the early vascular ageing Aristotle University Thessaloniki Study (EVA-ARIS Study). Atherosclerosis. 2011;219:194-9.
97.-Bilo G, Giglio A, Styczkiewicz K, Caldara G, Kawecka-Jaszcz K, Mancia G, Parati G. How to improve the assessment of 24-h blood pressure variability. Blood Press
Monit. 2005;10:321-3.
98.-Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML, De Bacquer DA.
Night-day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Hum Hypertens. 2009;23:645-53.
99.-Kim KI, Lee JH, Chang HJ, Cho YS, Youn TJ, Chung WY, Chae IH, Choi DJ, Park KU, Kim CH. Association between blood pressure variability and inflammatory marker in hypertensive patients. Circ J. 2008;72:293-8.
100.-Mena L, Pintos S, Queipo NV, Aizpurua JA, Maestre G, Sulbaran T. A reliable index for the prognostic significance of blood pressure variability. J Hypertens.
2005;23:505-11.
101.-Cay S, Cagirci G, Demir AD, Balbay Y, Erbay AR, Aydogdu S, Maden O.
Ambulatory blood pressure variability is associated with restenosis after percutaneous coronary intervention in normotensive patients. Atherosclerosis.
2011;219:951-7.
102.-Eto M, Toba K, Akishita M, Kozaki K, Watanabe T, Kim S, Hashimoto M, Sudoh N, Yoshizumi M, Ouchi Y. Reduced endothelial vasomotor function and enhanced