Blood Pressure Variability (BPV) as a Novel Digital Biomarker of Multisystem Risk and Diagnostic Insight:...

Area of Science:

• Cardiology
• Nephrology
• Neurology

Background:

• Hypertension is traditionally assessed by mean blood pressure.
• Emerging evidence highlights the prognostic value of blood pressure variability (BPV).
• Elevated BPV signifies hemodynamic stress, leading to vascular injury and end-organ damage.

Purpose of the Study:

• To review current evidence on the prognostic implications of BPV.
• To explore the pathophysiology, measurement techniques, and clinical impact of BPV.
• To examine the role of artificial intelligence (AI) in BPV monitoring and risk stratification.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Cochrane Library, Scopus, Web of Science).
• Included study types encompassed observational studies, cohorts, randomized trials, and meta-analyses.
• The review synthesized evidence on BPV's association with mortality, cardiovascular events, and end-organ damage.

Main Results:

• Higher BPV is linked to increased risks of cardiovascular mortality, stroke, heart failure, and chronic kidney disease progression.
• BPV contributes to end-organ damage, including cognitive decline and preeclampsia.
• Pathophysiological mechanisms involve autonomic dysregulation, arterial stiffness, endothelial dysfunction, and inflammation.

Conclusions:

• BPV is a critical, dynamic marker of multisystem risk, independent of mean blood pressure.
• Antihypertensive medications may influence BPV, though specific trials are limited.
• AI-driven devices offer potential for continuous BPV monitoring and personalized risk stratification.