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Blood pressure variability: a still underestimated topic
P Stiefel1, J Muñoz-García2, R Pino-Mejías2
1Clinical Epidemiology and Vascular Risk Unit, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío SAS/CSIC/Universidad de Sevilla, Sevilla, Spain; Internal Medicine, Clinical Unit for Comprehensive Medical Care (UCAMI), Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Revista Clinica Espanola
|May 20, 2026
Summary
Blood pressure variability is increasingly recognized for its clinical relevance. This review details methods for its assessment and highlights its association with various health conditions and mortality risks.
Area of Science:
- Cardiovascular Medicine
- Clinical Physiology
Background:
- Growing recognition of blood pressure variability's significance in recent years.
- Need to understand the methods and clinical implications of blood pressure variability.
Purpose of the Study:
- To review methods for assessing blood pressure variability.
- To discuss the clinical relevance and prognostic implications of blood pressure variability.
Main Methods:
- Description of various assessment methods: beat-to-beat, 24-h ambulatory blood pressure monitoring, home self-measurements, visit-to-visit measurements.
- Explanation of mathematical indices for quantifying blood pressure variability.
Main Results:
- Increased blood pressure variability is linked to conditions beyond vascular disease, including mental illness, COVID-19 severity, fractures, and cognitive impairment.
- Blood pressure variability influences hypertension progression, target organ damage, gestational hypertension, preeclampsia, and neonatal outcomes.
- Blood pressure variability impacts coronary and cerebrovascular disease development, prognosis, and complications, independent of mean arterial pressure.
Conclusions:
- Blood pressure variability is a crucial factor in cardiovascular health and disease.
- Assessment methods and clinical relevance of blood pressure variability are key areas of research.
- Blood pressure variability is associated with increased vascular and all-cause mortality.
Related Concept Videos
01:25Errors occurring during blood pressure monitoring
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
01:17Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
01:28Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:28Factors affecting Blood pressure
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
01:18Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...