Blood Pressure Variability in Neurodegenerative Disease: Evidence From a Large-Scale Remote Patient Monitoring Program.
5 affiliations
- 1Department of Kinesiology and Sport Sciences, University of Miami, Miami, Florida, USA.
- 2HealthSnap, Inc., Miami, Florida, USA.
- 3Department of Informatics and Health Data Science, University of Miami, Miami, Florida, USA.
- 4Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, Florida, USA.
- 5Tulane University, New Orleans, Louisiana, USA.
Abstract
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. 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. 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. 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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BibTeX
@article{smith2026blood,
title = {{Blood Pressure Variability in Neurodegenerative Disease: Evidence From a Large-Scale Remote Patient Monitoring Program.}},
author = {Wesley Smith and Joseph F Signorile and Azizi A Seixas and Debbie P Chung and Brittany Larsen and Craig Flanagan},
journal = {Journal of clinical hypertension (Greenwich, Conn.)},
year = {2026},
month = nov,
doi = {10.1111/jch.70379},
url = {https://europepmc.org/article/MED/42998901},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Blood Pressure Variability in Neurodegenerative Disease: Evidence From a Large-Scale Remote Patient Monitoring Program.
AU - Wesley Smith
AU - Joseph F Signorile
AU - Azizi A Seixas
AU - Debbie P Chung
AU - Brittany Larsen
AU - Craig Flanagan
PY - 2026
DA - 2026/11/01
JO - Journal of clinical hypertension (Greenwich, Conn.)
DO - 10.1111/jch.70379
UR - https://europepmc.org/article/MED/42998901
AB - 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. 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. 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. 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.
SN - 1524-6175
SN - 1751-7176
ER -