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March 31, 2026Clinical Autonomic Research

Elevated blood pressure variability links cardiac autonomic dysfunction to complex arrhythmias in hypertension

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Why the study?

The study aimed to investigate the relationship between short-term blood pressure variability, autonomic function measured by heart rate variability, and complex arrhythmias in hypertensive patients.

Does elevated short-term blood pressure variability correlate with cardiac autonomic dysfunction and complex arrhythmias in patients with primary hypertension?

Population

198 middle-aged and elderly patients with primary hypertension

Comparison

Patients stratified by tertiles of 24-h systolic blood pressure variability

Design

Retrospective observational study

Key result

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.

Authors

YYYang YouXHXiaoyan HanGQGuoqing Qi

Discussion

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Member takes

Overview

May flag high-risk hypertensives for closer monitoring; leaves open whether BPV modification reduces arrhythmias.

Key Points

  • This research aims to explore how short-term blood pressure variability connects with autonomic function and arrhythmia prevalence in hypertensive patients.
  • Retrospective analysis of 198 middle-aged and elderly patients with primary hypertension.
  • Assessment of 24-h ambulatory blood pressure and Holter monitoring, followed by echocardiography within 72 hours.
  • Analysis of HRV using time and frequency domains, with a composite autonomic score derived through principal component analysis.
  • High BPV group had a 71.2% incidence of complex arrhythmias compared to 40.9% in the low BPV group.
  • BPV was inversely correlated with HRV parameters, notably with SDNN.
  • Logistic regression identified higher BPV (OR needed), older age, and larger left atrial diameter as independent predictors of complex arrhythmias.

Study Design

Type

Observational (n=198)

Structured PICO

Does elevated short-term blood pressure variability correlate with cardiac autonomic dysfunction and complex arrhythmias in patients with primary hypertension?

P
Population
198 middle-aged and elderly patients with primary hypertension
I
Intervention
High 24-h systolic blood pressure variability (highest tertile)
C
Comparator
Low 24-h systolic blood pressure variability (lowest tertile)
O
Outcome
Prevalence of complex arrhythmias (defined as Lown grade ≥ 3 or Kleiger grade ≥ 3) and autonomic function measured by heart rate variability (HRV)surrogate

Main Result

Absolute Event Rate: 71.2% vs 40.9%

Increased short-term blood pressure variability in hypertensive patients is independently associated with impaired cardiac autonomic function and a higher prevalence of complex arrhythmias.

Cite This Study

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.

synapsesocial.com/papers/6a025bf7edf6f481385941adhttps://doi.org/10.1007/s10286-026-01199-z
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