Clinical implication of visit-to-visit blood pressure variability.

In clinical practice, out-of-office blood pressure (BP) measurements, i.e., ambulatory BP monitoring and home BP measurement, provide superior results, reproducibility, and evaluation of the effect of antihypertensive drugs compared with office BP measurement. However, following a report on the clinical impact of visit-to-visit BP variability, in addition to the results of a clinical trial, office BP measurement has regained prominence in clinical and research settings. Many reports have been published on the association between visit-to-visit BP variability and cardiovascular outcomes. However, other indexes of BP variability besides visit-to-visit BP variability can be evaluated in the office. In addition, methodology has been developed for calculation of visit-to-visit BP variability. Although most studies have shown a positive association between visit-to-visit BP variability and cardiovascular outcomes, this association was not observed in some studies. Further research is still needed for clarification.