# Research progress on the correlation between blood pressure variability and hypertensive microvascular disease

**Authors:** Shifeng Chen, Hongyu Kuang, Jie Zhu, Jia Wei, Pei Pan, Xinyu Hu, Ke Yang, Xiaoshu Yi, Huaan Du

PMC · DOI: 10.3389/fcvm.2026.1759344 · Frontiers in Cardiovascular Medicine · 2026-02-09

## TL;DR

This paper reviews how blood pressure variability contributes to microvascular damage in hypertension, independent of average blood pressure.

## Contribution

The paper systematically explores BPV's role as an independent risk factor for hypertensive microvascular disease.

## Key findings

- BPV is an independent risk factor for endothelial injury and target organ damage.
- Neurohumoral regulation, behavioral factors, and comorbidities influence BPV.
- BPV is closely linked to microvascular complications in diabetic and obese populations.

## Abstract

The hypertensive microvascular disorder is a significant complication that can lead to substantial target organ damages, including cognitive impairments, visual impairments, and deterioration in renal function. Recent studies have indicated that blood pressure variability (BPV) is an independent risk factor for the progression of this pathology. The present paper aims to systematically elucidate the concept, classification, and clinical significance of BPV, focusing on how it acts as a pathogenic mechanism independent of mean blood pressure to exacerbate endothelial injury and cause target organ damage. This review was conducted to evaluate the influences of multiple factors on BPV, including neurohumoral regulation, the behavioural environment and comorbidities. It also emphasises the intrinsic link between BPV and microvascular complication risk in specific populations, such as those with diabetes and obesity. In summary, it is evident that a comprehensive exploration of the underlying mechanisms of BPV is imperative for the early prevention and treatment of hypertensive microvascular diseases.

## Linked entities

- **Diseases:** diabetes (MONDO:0005015), obesity (MONDO:0011122)

## Full-text entities

- **Genes:** ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, REN (renin) [NCBI Gene 5972] {aka ADTKD4, HNFJ2, RTD}, ADIPOQ (adiponectin, C1Q and collagen domain containing) [NCBI Gene 9370] {aka ACDC, ACRP30, ADIPQTL1, ADPN, APM-1, APM1}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, VWF (von Willebrand factor) [NCBI Gene 7450] {aka F8VWF, VWD}
- **Diseases:** cognitive decline (MESH:D003072), chronic (MESH:D002908), atherosclerotic plaques (MESH:D058226), sleep-disordered breathing (MESH:D012891), coronary (MESH:D003323), dementia (MESH:D003704), type 1 diabetes (MESH:D003922), obstructive sleep apnoea (MESH:D020181), type 2 diabetes (MESH:D003924), transient ischaemic attacks (MESH:D002546), target organ damage (MESH:D000092124), kidney disease (MESH:D007674), cerebrovascular injury (MESH:D002561), endothelial injury (MESH:D057772), retinal microvascular structural degeneration (MESH:D012162), microvascular complications (OMIM:603933), myocardial infarction (MESH:D009203), Vascular remodelling (MESH:D066253), cardiovascular autonomic neuropathy (MESH:D002318), ESRD (MESH:D007676), ischemic lesions (MESH:D017202), orthostatic hypotension (MESH:D007024), ischaemic stroke (MESH:D002544), brain injury (MESH:D001930), BPV (MESH:D006973), elevated blood (MESH:D006402), diabetic target organ damage (MESH:D058065), cardiac death (MESH:D003643), haemorrhagic stroke (MESH:D002543), atherosclerosis (MESH:D050197), microvascular damage (MESH:D017566), abnormal (MESH:D000014), thrombosis (MESH:D013927), albuminuria (MESH:D000419), damage (MESH:D020263), HRD (MESH:D006977), overweight (MESH:D050177), deterioration in renal function (MESH:D058186), HR (MESH:D058437), Stroke (MESH:D020521), matter (MESH:D056784), Obesity (MESH:D009765), CKD (MESH:D051436), renal insufficiency (MESH:D051437), diabetes (MESH:D003920), arterial rupture (MESH:D012421), endothelial dysfunction (MESH:D014652), visual impairment (MESH:D014786), CHD (MESH:D003327), complications (MESH:D008107), inflammation (MESH:D007249), cerebral hypoperfusion (MESH:D002547), syncope (MESH:D013575), Metabolic syndrome (MESH:D024821)
- **Chemicals:** creatinine (MESH:D003404), ROS (MESH:D017382), amlodipine (MESH:D017311), lipid (MESH:D008055), potassium (MESH:D011188), sodium (MESH:D012964), BPV (-), NO (MESH:D009569), blood glucose (MESH:D001786), dihydropyridine (MESH:C038806), Aspirin (MESH:D001241), AGEs (MESH:D017127), aldosterone (MESH:D000450), cortisol (MESH:D006854)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12926386/full.md

## References

87 references — full list in the complete paper: https://tomesphere.com/paper/PMC12926386/full.md

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Source: https://tomesphere.com/paper/PMC12926386