Background
The exploration of Blood Pressure (BP) variability and of the influence of different antihypertensive drugs on BP variability may improve understanding of the mechanism involved in BP changes induced by drugs. We therefore evaluated the long-term effects of the angiotensin-receptor blocker Valsartan and of the ultraselective beta blocker Nebivolol.

Methods
A prospective study was conducted at the regional outpatient Diagnosis and Treatment Center from Cluj-Napoca, Romania. The study included newly diagnosed adult hypertensives of either sex. All patients underwent 24 hour ambulatory blood pressure monitoring (ABPM)  and systolic and diastolic 24 hour blood pressure variability was measured. A total of 80 hypertensive patients were randomely assigned to receive 80 mg of Valsartan or 5 mg of Nebivolol.Patients were divided into two groups according to antihypertensive medication: group A included 42 hypertensive patients treated with Valsartan and group B included 38 hypertensive patients treated with Nebivolol.

Results
Both Valsartan and Nebivolol decreased 24h BP variability but long-term treatment with Valsartan proved to be more efficient in reducing SBP variability during the night time period. Valsartan significantly reduces systolic BP variability during the night time period when compared to Nebivolol

Conclusions:
Treatment with ARBs (Valsartan) and BBs (Nebivolol) efficiently reduced the BP variability during the day and night period of time as first line antihypertensive agents. Valsartan significantly reduces systolic BP variability during the night time period when compared to Nebivolol. Antihypertensive treatment using long acting agents like an angiotensin receptor blocker or an ultraselective beta blocker could offer a better cardiovascular protection by reducing the BP variability.