Daytime blood pressure variability was primarily driven by mean BP values and age, while kidney function was associated with nocturnal hypertension and impaired dipping rather than daytime BPV.
Cross-Sectional (n=90)
What are the determinants of daytime blood pressure variability and does it correlate with kidney function in adults undergoing 24-hour ABPM?
Daytime blood pressure variability is primarily driven by mean blood pressure and age, whereas kidney function is more strongly associated with nocturnal hypertension and impaired dipping.
Effect estimate: ß=0.355 (95% CI 0.03-0.12)
p-value: p=0.003
Objective: Blood pressure variability (BPV), as measured by ambulatory blood pressure monitoring (ABPM), is a prognostic marker of cardiovascular risk; however, its role in management remains unclear. Furthermore, its routine use in patients with chronic kidney disease (CKD) is not yet established. We aimed to explore determinants of daytime BPV and its correlation to kidney function. Design and method: Consecutive adults undergoing 24-hour ABPM were analysed. Daytime systolic and diastolic BPV were quantified as the standard deviation (SD) of all daytime readings. Daytime heart rate SD, comorbidities, and laboratory results were recorded. Statistical analysis was performed using commercially available SPSS® (version 31.0, Chicago, IL, USA). Results: We included 90 patients (45.6% female), aged 62±17 years, with CKD in 55.6% and resistant hypertension in 37.8%. The cohort's mean systolic and diastolic BPs were 138.8±16.7 and 75.5±10.5 mmHg, respectively. Mean daytime systolic BPV and diastolic BPV were 14.4 and 10.1 mmHg. Daytime systolic BPV correlated with 24-hour systolic BP (r=0.277; p=0.008) and daytime systolic BP (r=0.278; p=0.008). Daytime diastolic SD correlated with 24-hour diastolic blood pressure BP (r=0.296; p=0.005) and daytime diastolic BP (r=0.317; p=0.002). Kidney function (eGFR) showed no significant association with daytime systolic or diastolic BPV. Regardless of CKD status, mean BP values did not differ significantly. However, CKD was associated with higher nocturnal systolic blood pressure (140.5±19.8 vs 128.3±17.0 mmHg; p=0.002) and blunted systolic dipping (1.2±6.9% vs 7.4±8.0%; p<0.001). In a multivariate-adjusted linear regression model, systolic BPV was associated with higher systolic BP and age (ß=0.355; 95% CI 0.03–0.12; p=0.003; and ß=0.311; 95% CI 0.01–0.12; p=0.034), after adjustment for gender, BMI, kidney function, and diabetes mellitus. Conclusions: In this cohort, daytime BPV was primarily driven by mean BP values and age. In contrast, kidney function was mainly associated with nocturnal hypertension and impaired dipping rather than increased daytime BPV.
Petreski et al. (2026) conducted a cross-sectional in Chronic kidney disease and resistant hypertension (n=90). Daytime blood pressure variability was evaluated on Determinants of daytime systolic BPV (association with systolic BP) (ß=0.355, 95% CI 0.03-0.12, p=0.003). Daytime blood pressure variability was primarily driven by mean BP values and age, while kidney function was associated with nocturnal hypertension and impaired dipping rather than daytime BPV.