Hypertensive urgency or high blood pressure variability?

Hypertensive urgency (HU) is a common reason particularly for elderly patients to seek medical advice. Severe asymptomatic hypertension and situational high blood pressure (BP) in patients with its high variability is frequently taken as HU. The use of short-acting antihypertensive drugs is not only indicated in these situations, but it may also increase the risk of cardiovascular events (CVE). Over the past decade, increased BP variability is an independent predictor for a higher risk of CVE. Among the major groups of antihypertensive drugs, there are calcium antagonists, mainly amlodipine, which has the greatest potential to reduce BP variability. Thus, calcium antagonists can be considered as first-line drugs for patients with high BP variability.