Znaczenie prognostyczne zmienności rytmu serca i zmienności ciśnienia tȩtniczego u pacjentów z nadciśnieniem tȩtniczym

In recent years heart rate variability (HRV) and blood pressure variability (BPV) have been extensively studied as parameters reflecting changes in cardiovascular autonomic function. Autonomic dysfunction is more frequent in hypertensives than in normotensives. At present there are no studies focusing on the prognostic value of HRV in hypertensives. There are no clearly defined recommendations for use of HRV in routine practice, either. For this reason, it is not clear whether the detection of low/ /high HRV should have any clinical implications. However, evidence shows that HRV may have a significant predictive value in the development of arterial hypertension. BPV has been documented as a prognostic factor for the development of target organ injury in hypertension and cardiovascular mortality. The prognostic value of global blood pressure variability (SD) and nocturnal blood pressure fall is better documented than that of morning blood pressure surge. The present paper provides the results of studies divided into cross-sectional and prospective. Despite the proved prognostic value, BPV is not widely used due to a lack of recommendations on the optimal BPV indices, reference values and limited knowledge of therapeutic modulation of BPV. This status has been reflected in the newest guidelines of the ESH and ESC, in which BPV was included as a promising parameter, but still under study and not recommended for use in clinical practice.