Objective: Home blood pressure (BP) variability (HBPV) is a significant predictor of cardiovascular events, but gender differences in the drug treatment effect on HBPV remains uncertain. Our purpose was to compare the effect of 6 month (M) standardized algorithmic treatment on HBPV in men and women <75 years with uncomplicated hypertension (UH). Design and method: To PERFECT-BP prospective observational study (ISRCTN75706523) subanalysis were included 209 newly diagnosed (14,4%) or treated but uncontrolled (BP<200/120 mmHg) UH patients (pts) aged 59 ± 9,5, 89 (42,6%) male, 120 (57,4%) female, 27 (12,9%) diabetics. Home BP monitoring (HBPM) was performed by standardized automatic Microlife BP3AG1 device with individually selected cuff, thrice in the morning and in the evening, for 7 consecutive days before each visit at day 7, M1, 2, 3, 6. At visit 1 pts were prescribed or switched to perindopril/amlodipine fixed-dose combination (FDC). Step 2 was FDC uptitration, step 3 – indapamide SR, step 4 – spironolactone, step 5 – moxonidine or doxazosin. HBPV was defined as the standard deviation (SD) and the coefficient of variation (CV) of the daily BP average of 6 readings of 7 consecutive days (42 BP readings). Results: By 6 M, target office BP was attained in 71 (79,8%) men vs 103 (85,8%; p > 0,05) women, home BP<135/85 mmHg – in 51 (57,3%) vs 87 (72,5%, p < 0,03) and both – in 47 (52,8%) vs 80 (66,7%, p < 0,05). Home systolic BP (SBP) in men and women reduced from 148,8 ± 17,9 and 145,7 ± 16,8 mmHg (p < 0,05) to 134,7 ± 12,2 and 129,4 ± 10,8 mmHg (p < 0,01), diastolic (DBP) – from 87,3 ± 10,5 and 83,6,5 ± 9,8 mmHg (p < 0,05) to 79,5 ± 7,9 and 77,4 ± 5,7 mmHg (p > 0,05); home SBP SD – from 8,2 ± 3,5 and 8,8 ± 4,6 mmHg (p > 0,05) to 4,9 ± 2,4 and 6,2 ± 3,7 mmHg (p < 0,001), SBP CV – from 5,2 ± 2,2 and 5,7 ± 2,6% (p > 0,05) to 3,8 ± 1,5 and 4,5 ± 2% (p < 0,01); home DBP SD – from 5,7 ± 3 and 6,1 ± 3 mmHg (p > 0,05) to 3,6 ± 2 and 4,9 ± 3 mmHg (p < 0,01), CV – from 6,1 ± 3 and 6,9 ± 3% (p > 0,05) to 4,7 ± 2 and 5,9 ± 3% (p < 0,01). Conclusions: Better home BP control in women compared to men is associated with higher rates of home SBP and DBP variability after 6 M of standardized algorithmic treatment based on FDC in real life setting.