Background: Increased blood pressure variability (BPV) is associated with adverse cardiovascular outcomes, particularly incident stroke. However, the impact of increased BPV on target-organ damage related to hypertension is unknown. This study aimed to determine the effect of BPV compared with conventional average BP on left ventricular mass index (LVMI).

Methods: BPV and conventional average BP (24-hour ambulatory BP, 7-day home BP and office BP) were assessed in 286 patients with uncomplicated treated hypertension (aged 64±8 years, 54% male) over 12-months. Short-term BPV (from 24 hour ambulatory BP) was assessed at baseline and 12-months, mid-term BPV (from 7 day home BP) was assessed at 3-month intervals, and long-term BPV (from clinic BP) was assessed from 5 visits over 12-months. Left ventricular mass index (LVMI) was derived from 3-dimensional echocardiography.

Results: Mean changes in LVMI over 12 months were 0.01±2.5 g/m^−2.7. The strongest independent predictor of the change in LVMI was conventional 24-hour ambulatory systolic BP (β=0.032; P=0.02). However, none of the changes in short-term, mid-term or long-term BPV were associated with changes in LVMI (all P>0.05).

Conclusions: The change in conventional average 24-hour ambulatory BP, but not BPV, is relevant to changes in target organ damage determined from LVMI in patients with uncomplicated hypertension. Thus, BPV does not provide additive information on BP control in this patient population.