Daytime systolic ARV ≥11.4 mmHg shows the strongest independent association with increased arterial stiffness, while diastolic ARV indices remain significant but weaker predictors.
Daytime systolic ARV ≥11.4 mmHg was identified as the optimal threshold for predicting increased arterial stiffness (cfPWV ≥10 m/s).
After multivariable adjustment, daytime systolic ARV remained independently associated with cfPWV ≥10 m/s.
All diastolic ARV indices were also independently associated with increased arterial stiffness, though with lower effect sizes than systolic ARV.
Blood pressure variability assessed by ARV is an independent cardiovascular risk factor associated with target organ damage beyond mean blood pressure levels.
ROC analysis was used to identify clinically relevant ARV thresholds for detecting increased arterial stiffness in a sample of 315 adults.
This research suggests that how much a person's blood pressure fluctuates throughout the day — not just the average level — is an important indicator of arterial stiffness, a key marker of cardiovascular risk. The study measured a specific type of blood pressure variability called Average Real Variability (ARV) using 24-hour blood pressure monitors in 315 adults, and then assessed the stiffness of their arteries using a technique called pulse wave velocity (PWV), which measures how fast a pressure wave travels through the arteries. Stiffer arteries produce faster wave speeds, and a threshold of 10 meters per second was used to define increased stiffness. The researchers found that when daytime systolic (top number) blood pressure variability reached or exceeded 11.4 mmHg, it was strongly associated with having increased arterial stiffness — even after accounting for age, sex, and average blood pressure levels. People with this level of variability were more than five times more likely to have increased arterial stiffness compared to those below the threshold. Variability in diastolic (bottom number) blood pressure also predicted arterial stiffness, but less strongly. This research suggests that monitoring how much blood pressure varies during the day, rather than focusing solely on average blood pressure values, may help identify people at greater cardiovascular risk. A daytime systolic ARV of 11.4 mmHg emerged as a potentially clinically useful cut-off point. These findings highlight that blood pressure variability could be an additional tool for assessing cardiovascular health, particularly in identifying early arterial damage in people with hypertension.
Wasiliew S, Lipski D, Chicheł-Szczepaniak L, Kostka-Jeziorny K, Żurek S, Tykarski A, et al.. (2026). Average Real Variability Is an Independent Predictor of Increased Arterial Stiffness Assessed by Pulse Wave Velocity.. Journal of clinical hypertension (Greenwich, Conn.). https://doi.org/10.1111/jch.70355