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Am J Hypertens. 2013 Dec;26(12):1369-76. doi: 10.1093/ajh/hpt167. Epub 2013 Sep 30.

Visit-to-visit blood pressure variability, silent cerebral injury, and risk of stroke.

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Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.


Apart from the well-known role of hypertension in cerebrovascular disease, visit-to-visit blood pressure (BP) variability is emerging as an independent risk factor for stroke. Although the underlying mechanism is not fully understood, artery remodeling is thought to be closely involved in the relationship between visit-to-visit BP variability and stroke. This review article summarizes the recent literature on these topics. Silent cerebral injury is considered to serve as a common pathophysiology in the relationship of visit-to-visit BP variability with cognitive impairment and stroke. Here we review visit-to-visit BP variability, some comparisons of the effects of antihypertensive agents on visit-to-visit BP variability, and an issue regarding the impact of these agents on stroke.


blood pressure; blood pressure variability; cognitive impairment.; silent cerebral injury; stroke

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