Importancia de variabilidad de la presión arterial. Articulo de revisión. Cardiología.

A topic review about circadian rhythm and variability of blood pressure (BP), the association with target organ damage in essential hypertension and mechanisms involved in BP variability was done. The most significant circadian variation of the blood pressure describe was the morning surge of blood pressure, a morning increase of the BP and its variability greater than in the rest of the day, the white coat hypertension, a term used to describe blood pressure that only seems to be high when someone comes in to the doctor's office and the changes in the patron of BP lowering during the nocturnal rest. The nocturnal BP decline patients are classified as dippers or non-dippers. Dividing the patients into four possible groups has extended this classification: extreme-dippers (sleep-time relative BP decline more than 20%), dippers (decline between 10% and 20%), non-dippers (decline less than10%), and inverse dippers or risers (decline 0%, indicating sleep-time BP greater than awake BP mean). The association between target organ damage, cardiovascular disease and the BP variability is describe. The most important conclusion was that the adverse effect of the hypertension over the cardiovascular system is not only determined by the severity either by the variability of the BP. Key words: ABPM, circadian rhythm, white coat hypertension, non-dippers, dippers, morning surge.