Key result
Increased short-term blood pressure variability is associated with detrimental effects on microvascular structure and contributes to subclinical organ damage and adverse kidney outcomes.
Why the study?
The additional role of short-term BPV beyond average 24-h BP remains unclear, with limited longitudinal data evaluating its link to kidney impairment, uncertain prognostic metrics, and unclear treatment strategies.
Does short-term blood pressure variability predict adverse kidney outcomes and progression of chronic kidney disease?
Does short-term blood pressure variability predict adverse kidney outcomes and progression of chronic kidney disease?
Short-term blood pressure variability is a significant predictor of kidney disease onset and progression, highlighting its potential as an independent risk modifier and therapeutic target beyond average blood pressure control.
May flag higher-risk CKD patients; leaves open whether targeting variability improves outcomes.
Short-term blood pressure variability (BPV) measured with ambulatory blood pressure (BP) monitoring has been demonstrated to be significant in predicting various clinical outcomes. Short-term BPV is distinguished from long-term BPV based on the time interval in which BP fluctuations are measured. Increased short-term BPV has been linked to detrimental effects on the microvascular structure and contributes to subclinical organ damage in the heart, blood vessels, and kidneys, regardless of the average 24-h BP levels. Short-term BPV can be defined by various measures, including calculated metrics (standard deviation, coefficient of variation, average real variability, weighted standard deviation, variability independent of the mean) or dipping patterns. Nevertheless, the additional role of short-term BPV beyond the predictive value of average 24-h BPs or established risk factors for cardiovascular disease and kidney disease remains unclear. In particular, longitudinal studies that evaluate the association between short-term BPV and kidney function impairment are limited and no conclusive data exist regarding which short-term BPV indicators most accurately reflect the prognosis of kidney disease. The issue of how to treat BPV in clinical practice is another concern that is frequently raised. This paper presents a review of the evidence for the prognostic role of short-term BPV in kidney outcomes. Additionally, this review discusses the remaining concerns about short-term BPV that need to be further investigated as an independent risk modifier.
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Ko et al. (2023) conducted a review in Kidney disease. Short-term blood pressure variability was evaluated. Increased short-term blood pressure variability is associated with detrimental effects on microvascular structure and contributes to subclinical organ damage and adverse kidney outcomes.
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