الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Blood pressure variability (BPV) is a complex phenomenon that includes both short term and long-term components, which can be estimated by the standard deviation of the blood pressure values over a defined period of the day or by the night-to-day blood pressure ratio.
The Ambulatory blood-pressure monitoring (APBM) can provide the following three types of information, which are of potential value in the clinical field: estimatemation of the true, or mean, blood-pressure level, the diurnal rhythm of blood pressure, and blood-pressure variability.
In the present study we aimed to evaluate the determinants of blood pressure variability in hypertensive patients presented to Alexandria Main University Hospital, Cardiology Department, either as outpatients or during hospitalization.
The study included 114 patients, 96 patients were presented with primary hypertension, the onset of which was variable, and with different grade of hypertension. We exclude patients with secondary hypertension, cardiac and renal problems.
All patients were subjected to through history taking (Questions about onset, Questions about the course, Questions about risk factors or any other disease if present and Questions about the background (past medical history), Physical examination ( blood pressure, pulse and complete cardiac examination), Blood tests ( complete blood count , blood glucose and serum electrolytes) , Standard 12 lead ECG for evidence of left ventricular hypertrophy, Conventional transthoracic echocardiography for detection of exclusion criteria, systolic and diastolic function and the presence of left ventricular hypertrophy. and Ambulatory blood pressure monitoring.
In this study, male ratio was 57.9%. 96 patients previously diagnosed as hypertensive patients were classified according to degree of hypertension to Mild hypertension group ( 31.6 %), Moderate Hypertension group 40.4 % and sever hypertension group( 12.3 % ), all patients classified according to the presence of DM into non- diabetics (75 .4 %) and Diabetics (24.6 %). 59.6 % of patients were diagnosed as dipper and 40.4 % as non-dipper. Patients classified according to standard deviation of systolic and diastolic blood pressure values into normal and abnormal groups with a cut-off value of 11 (by using ROC curve).
After performing 24h Ambulatory blood pressure monitoring, Mean day time, night time and 24h for systolic, diastolic pressures and heart rate also the standard deviation of blood pressure variability were calculated. We used those data in detecting the determinant of variability of blood pressure through variants like age, sex, diabetes, dipping, antihypertensive medications and grade of hypertension, also the relation of variability to the mean values of blood pressure were studied.