{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:35:46Z","timestamp":1790948146763,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:00:00Z","timestamp":1695513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Blood pressure oscillations during different time scales, known as blood pressure variability (BPV), have become a focus of growing scientific interest. BPV can be measured at long-term (seasonal variability or visit-to-visit), at mid-term (differences in consecutive days or weeks) or at short-term (day-night differences or changes induced by other daily activities and conditions). An increased BPV, either at long, mid or short-term is associated with a poor cardiovascular prognosis independently of the amount of blood pressure elevation. There is scarce evidence on the effect of different antihypertensive treatments on BPV, but some observational and interventional studies suggest that calcium channel blockers in general, and particularly amlodipine, either in monotherapy or combined with renin-angiotensin system blockers, can reduce BPV more efficiently than other antihypertensive drugs or combinations. Nevertheless, there are several aspects of the relationship between BPV, antihypertensive treatment, and clinical outcomes that are still unknown, and more work should be performed before considering BPV as a therapeutical target in clinical practice.<\/jats:p>","DOI":"10.3390\/jcm12196167","type":"journal-article","created":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:48:31Z","timestamp":1695552511000},"page":"6167","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Blood Pressure Variability as a Risk Factor for Cardiovascular Disease: Which Antihypertensive Agents Are More Effective?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-5497","authenticated-orcid":false,"given":"Alejandro","family":"de la Sierra","sequence":"first","affiliation":[{"name":"Hospital Mutua Terrassa, University of Barcelona, 08221-Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1038\/s41569-021-00559-8","article-title":"Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension","volume":"18","author":"Zhou","year":"2021","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_2","first-page":"1795","article-title":"2023 ESH Guidelines for the management of arterial hypertension","volume":"41","author":"Mancia","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/HJH.0000000000003363","article-title":"Blood pressure variability: Methodological aspects, clinical relevance and practical indications for management\u2014A European Society of Hypertension position paper","volume":"41","author":"Parati","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/nrcardio.2013.1","article-title":"Assessment and management of blood-pressure variability","volume":"10","author":"Parati","year":"2013","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1161\/01.HYP.32.1.52","article-title":"Estimation of blood pressure variability from 24-hour ambulatory finger blood pressure","volume":"32","author":"Omboni","year":"1998","journal-title":"Hypertension"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.amjhyper.2004.05.002","article-title":"Blood pressure variability and silent cerebral damage in essential hypertension","volume":"17","author":"Sierra","year":"2004","journal-title":"Am. J. Hypertens."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1097\/HJH.0b013e328363e964","article-title":"European Society of Hypertension position paper on ambulatory blood pressure monitoring","volume":"31","author":"Parati","year":"2013","journal-title":"J. Hypertens."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1097\/HJH.0000000000002922","article-title":"Home blood pressure monitoring: Methodology, clinical relevance and practical application: A 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension","volume":"39","author":"Parati","year":"2021","journal-title":"J. Hypertens."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S1474-4422(10)70066-1","article-title":"Effects of beta blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke","volume":"9","author":"Rothwell","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1097\/HJH.0b013e32829c6a60","article-title":"A new method for assessing 24-h blood pressure variability after excluding the contribution of nocturnal blood pressure fall","volume":"25","author":"Bilo","year":"2007","journal-title":"J. Hypertens."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/01.hjh.0000160205.81652.5a","article-title":"A reliable index for the prognostic significance of blood pressure variability","volume":"23","author":"Mena","year":"2005","journal-title":"J. Hypertens."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/S0140-6736(10)60308-X","article-title":"Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension","volume":"375","author":"Rothwell","year":"2010","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1161\/HYPERTENSIONAHA.112.193094","article-title":"Association between annual visit-to-visit blood pressure variability and stroke in postmenopausal women: Data from the Women\u2019s Health Initiative","volume":"60","author":"Shimbo","year":"2012","journal-title":"Hypertension"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/HJH.0000000000000028","article-title":"Second Australian National Blood Pressure Study Management Committee. Systolic blood pressure variability is an important predictor of cardiovascular outcomes in elderly hypertensive patients","volume":"32","author":"Chowdhury","year":"2014","journal-title":"J. Hypertens."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"329","DOI":"10.7326\/M14-2803","article-title":"Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure, and mortality: A cohort study","volume":"163","author":"Muntner","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1161\/HYPERTENSIONAHA.117.09359","article-title":"ADVANCE Collaborative Group. Prognostic value of variability in systolic blood pressure related to vascular events and premature death in type 2 diabetes mellitus: The ADVANCE-ON Study","volume":"70","author":"Ohkuma","year":"2017","journal-title":"Hypertension"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/HJH.0000000000001159","article-title":"Visit-to-visit blood pressure variability is a risk factor for all-cause mortality and cardiovascular disease: A systematic review and meta-analysis","volume":"35","author":"Wang","year":"2017","journal-title":"J. Hypertens."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1161\/HYPERTENSIONAHA.107.104620","article-title":"Day-by-day variability of blood pressure and heart rate at home as a novel predictor of prognosis: The Ohasama study","volume":"52","author":"Kikuya","year":"2008","journal-title":"Hypertension"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1161\/HYPERTENSIONAHA.111.178657","article-title":"Prognostic value of the variability in home-measured blood pressure and heart rate: The Finn-Home Study","volume":"59","author":"Johansson","year":"2012","journal-title":"Hypertension"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1161\/HYPERTENSIONAHA.116.08603","article-title":"Outcome-driven thresholds for increased home blood pressure variability","volume":"69","author":"Juhanoja","year":"2017","journal-title":"Hypertension"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1161\/HYPERTENSIONAHA.112.202143","article-title":"Within-subject blood pressure level\u2014Not variability\u2014Predicts fatal and nonfatal outcomes in a general population","volume":"60","author":"Schutte","year":"2012","journal-title":"Hypertension"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1177\/2047487319872572","article-title":"The impact of systolic and diastolic blood pressure variability on mortality is age dependent: Data from the Dublin Outcome Study","volume":"27","author":"Bilo","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1161\/HYPERTENSIONAHA.114.03694","article-title":"Added predictive value of night-time blood pressure variability for cardiovascular events and mortality: The Ambulatory Blood Pressure-International Study","volume":"64","author":"Palatini","year":"2014","journal-title":"Hypertension"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"i4098","DOI":"10.1136\/bmj.i4098","article-title":"Blood pressure variability and cardiovascular disease: Systematic review and meta-analysis","volume":"354","author":"Stevens","year":"2016","journal-title":"BMJ"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1161\/HYPERTENSIONAHA.109.140798","article-title":"Prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations","volume":"55","author":"Hansen","year":"2010","journal-title":"Hypertension"},{"key":"ref_26","first-page":"397","article-title":"Dippers and non-dippers","volume":"2","author":"Sheridan","year":"1988","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1161\/HYPERTENSIONAHA.108.124008","article-title":"Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients","volume":"53","author":"Redon","year":"2009","journal-title":"Hypertension"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/S0140-6736(23)00733-X","article-title":"Relationship between clinic and ambulatory blood pressure and mortality. An observational cohort study in 59,124 patients","volume":"401","author":"Banegas","year":"2023","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1161\/01.CIR.0000056521.67546.AA","article-title":"Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: A prospective study","volume":"107","author":"Kario","year":"2003","journal-title":"Circulation"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1161\/HYPERTENSIONAHA.115.05958","article-title":"Ethnic differences in the degree of morning blood pressure surge and in its determinants between Japanese and European hypertensive subjects: Data from the ARTEMIS study","volume":"66","author":"Hoshide","year":"2015","journal-title":"Hypertension"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(15)01225-8","article-title":"Blood pressure lowering for prevention of cardiovascular disease and death: A systematic review and meta-analysis","volume":"387","author":"Ettehad","year":"2016","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.jash.2014.02.004","article-title":"Effects of amlodipine and other classes of antihypertensive drugs on long-term blood pressure variability: Evidence from randomized controlled trials","volume":"8","author":"Wang","year":"2014","journal-title":"J. Am. Soc. Hypertens."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1161\/CIRCULATIONAHA.105.595496","article-title":"Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: Principal results of the Conduit Artery Function Evaluation (CAFE) study","volume":"113","author":"Williams","year":"2006","journal-title":"Circulation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/HJH.0000000000003033","article-title":"Effect of dihydropyridine calcium channel blockers on blood pressure variability in the SPRINT trial: A treatment effects approach","volume":"40","author":"Petersen","year":"2022","journal-title":"J. Hypertens."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"411","DOI":"10.3109\/10641963.2014.995802","article-title":"Visit-to-visit variability and seasonal variation in blood pressure: Combination of Antihypertensive Therapy in the Elderly, Multicenter Investigation (CAMUI) Trial subanalysis","volume":"37","author":"Sato","year":"2015","journal-title":"Clin. Exp. Hypertens."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1161\/HYPERTENSIONAHA.111.189217","article-title":"Combined effect of angiotensin II receptor blocker and either a calcium channel blocker or diuretic on day-by-day variability of home blood pressure: The Japan Combined Treatment with Olmesartan and a Calcium-Channel Blocker Versus Olmesartan and Diuretics Randomized Efficacy Study","volume":"59","author":"Matsui","year":"2012","journal-title":"Hypertension"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/jdi.12052","article-title":"Beneficial effect of calcium channel blockers on home blood pressure variability in the morning in patients with type 2 diabetes","volume":"8","author":"Ushigome","year":"2013","journal-title":"J. Diabetes Investig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1161\/HYPERTENSIONAHA.111.174383","article-title":"Effect of antihypertensive agents on blood pressure variability: The Natrilix SR versus candesartan and amlodipine in the reduction of systolic blood pressure in hypertensive patients (X-CELLENT) study","volume":"58","author":"Zhang","year":"2011","journal-title":"Hypertension"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1038\/hr.2014.33","article-title":"Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension","volume":"37","author":"Tropeano","year":"2014","journal-title":"Hypertens. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/HJH.0000000000002618","article-title":"Antihypertensive therapy and short-term blood pressure variability","volume":"39","author":"Mateu","year":"2021","journal-title":"J. Hypertens."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1093\/ajh\/hpw085","article-title":"Renal Denervation vs. Spironolactone in Resistant Hypertension: Effects on Circadian Patterns and Blood Pressure Variability","volume":"30","author":"Pareja","year":"2017","journal-title":"Am. J. Hypertens."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/HJH.0000000000001582","article-title":"Blood pressure response to renal denervation is correlated with baseline blood pressure variability: A patient-level meta-analysis","volume":"36","author":"Persu","year":"2018","journal-title":"J. Hypertens."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1097\/HJH.0000000000003224","article-title":"European Society of Hypertension recommendations for the validation of cuffless blood pressure measuring devices: European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability","volume":"40","author":"Stergiou","year":"2022","journal-title":"J. Hypertens."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6167\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:57:10Z","timestamp":1760129830000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,24]]},"references-count":43,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196167"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196167","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,24]]}}}