High 24-h systolic blood pressure variability was associated with a higher incidence of complex arrhythmias compared to low variability (71.2% vs 40.9%) in hypertensive patients.
Observational (n=198)
Does elevated short-term blood pressure variability correlate with cardiac autonomic dysfunction and complex arrhythmias in patients with primary hypertension?
Increased short-term blood pressure variability in hypertensive patients is independently associated with impaired cardiac autonomic function and a higher prevalence of complex arrhythmias.
Absolute Event Rate: 71.2% vs 40.9%
PURPOSE: This study investigated the relationship between short-term blood pressure variability (BPV), autonomic function measured by heart rate variability (HRV), and the prevalence of complex arrhythmias in hypertensive patients. METHODS: We retrospectively analyzed 198 middle-aged and elderly patients with primary hypertension, stratified by tertiles of 24-h systolic BPV. Simultaneous 24-h ambulatory blood pressure and Holter monitoring were performed. Echocardiography was performed within 72 h of monitoring. HRV was analyzed in time and frequency domains, and a composite autonomic score was derived via principal component analysis. Complex arrhythmia was defined as Lown grade ≥ 3 or Kleiger grade ≥ 3. RESULTS: The high-BPV group showed significantly reduced HRV across all indices and a higher incidence of complex arrhythmias (71.2% versus 40.9% in low-BPV group). BPV was inversely correlated with all HRV parameters, most strongly with SDNN. Multivariate analysis confirmed BPV as an independent negative predictor of the composite autonomic score. Logistic regression adjusted for medication use identified higher BPV, older age, and larger left atrial diameter as independent predictors of complex arrhythmias. CONCLUSIONS: Increased short-term BPV is independently associated with impaired cardiac autonomic function and is a significant predictor of complex arrhythmias in hypertension. Assessment of BPV may improve autonomic and arrhythmic risk stratification in this population.
You et al. (2026) conducted an observational in primary hypertension (n=198). High 24-h systolic blood pressure variability vs. Low 24-h systolic blood pressure variability was evaluated on incidence of complex arrhythmias. High 24-h systolic blood pressure variability was associated with a higher incidence of complex arrhythmias compared to low variability (71.2% vs 40.9%) in hypertensive patients.