Key result
Neurodegenerative disease is linked to ~16% higher day-to-day systolic blood pressure variability.
Why the study?
The physiologic determinants of blood pressure variability in specific populations remain incompletely defined, and neurodegenerative diseases are associated with autonomic dysfunction that may alter blood pressure regulation.
Do patients with neurodegenerative disease exhibit greater day-to-day systolic blood pressure variability during long-term remote home monitoring compared with propensity-matched controls without neurodegenerative disease?
Cohort (n=196)
Yes
Do patients with neurodegenerative disease exhibit greater day-to-day systolic blood pressure variability during long-term remote home monitoring compared with propensity-matched controls without neurodegenerative disease?
Patients with neurodegenerative disease exhibit significantly elevated day-to-day systolic and diastolic blood pressure variability on home remote patient monitoring despite having the same mean blood pressure as matched controls, highlighting remote BPV tracking as a potential marker of autonomic dysfunction and cardiovascular risk.
Answers are grounded in this paper and cite their sources.
Neurodegenerative disease was associated with higher BP variability; hypothesis-generating for autonomic dysfunction, should not yet change practice.
Background Blood pressure variability (BPV) is an established predictor of cardiovascular risk, yet its physiologic determinants in specific populations remain incompletely defined. Neurodegenerative diseases are associated with autonomic dysfunction that may alter blood pressure regulation. Methods We compared day‐to‐day systolic blood pressure (SBP) variability between patients with neurodegenerative disease and matched controls in a retrospective analysis of de‐identified home blood pressure data from a remote patient monitoring platform. Eligible patients transmitted readings on at least three days per week over a monitoring stretch of at least eight weeks. Patients with Alzheimer's disease, Parkinson's disease, or dementia were propensity‐matched 1:3 to controls on age, mean SBP, mean diastolic blood pressure (DBP), stretch duration, and days per week with readings. The primary metric was average real variability (ARV), the mean absolute difference between consecutive values; standard deviation (SD) and variability independent of the mean (VIM) were secondary metrics. Results The matched cohort included 49 neurodegenerative patients and 147 controls. SBP ARV was higher in the neurodegenerative group (median 12.92 [IQR 10.74–15.35] vs. 11.19 [9.46–12.99] mmHg; p = 0.003), as was DBP ARV (7.72 [6.34–8.87] vs. 6.76 [5.67–7.75] mmHg; p = 0.002). SD and VIM results were concordant (all p ≤ 0.001). Mean blood pressure, monitoring duration, measurement frequency, and reading timing were comparable between groups. Conclusions Neurodegenerative disease is associated with elevated day‐to‐day BPV despite similar mean blood pressure and monitoring behavior, suggesting that routine home monitoring may reveal autonomic dysregulation and cardiovascular risk beyond mean blood pressure alone.
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Smith et al. (2026) conducted a cohort in Neurodegenerative disease (Alzheimer's disease, Parkinson's disease, or dementia) (n=196). Neurodegenerative disease diagnosis (Alzheimer's disease, Parkinson's disease, or dementia) vs. Propensity-matched non-neurodegenerative controls (1:3 matching on age, mean SBP, mean DBP, stretch duration, and days per week with readings) was evaluated on Day-to-day systolic blood pressure average real variability (SBP ARV, mmHg) (Rank-biserial correlation 0.280, 95% CI 0.083-0.470, p=0.003). Neurodegenerative disease was associated with a 15.5% higher median day-to-day systolic blood pressure average real variability compared to matched controls (12.92 vs 11.19 mmHg; p=0.003).
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