Studies on blood pressure variability and pathogenic mechanisms of cardiovascular risk in secondary hypertension

Understanding the complex mechanisms associated with systemic arterial hypertension represents a global health challenge, especially in secondary forms of hypertension. These occur in >10% of cases, mostly in younger people, and are often associated with poor blood pressure control and higher cardiovascular risk. This doctoral thesis highlights that, besides blood pressure values, multiple aspects of arterial hypertension, such as blood pressure variability and sleep disorders, should be taken into consideration as additional tools in clinical management and cardiovascular risk stratification of hypertensive patients with secondary forms, e.g., pheochromocytoma, renal artery fibromuscular dysplasia, and chronic kidney disease. Furthermore, most common sleep disorders (i.e., obstructive sleep apnoea) are frequently linked to increases in blood pressure variability, which represents an additional cardiovascular risk factor. Moreover, the analysis of pathogenic mechanisms that link sleep disorders to arterial hypertension represents an unmet research need. Results obtained in the second part of this thesis open new perspectives on potential pathogenic systems involved in obstructive sleep apnoea, hypertension, and cardiovascular diseases.