Blood pressure (BP) is one of the most dynamic physiologic variables that is routinely measured in clinical practice and is characterized by continuous and significant changes beat-to-beat, over 24 h, day-to-day, and visit-to-visit. Under physiological conditions, these BP variations largely represent a response to environmental stimulations and challenges of daily life aimed at maintaining so-called cardiovascular “homeostasis”. However, sustained increases in blood pressure variability (BPV) may also reflect alterations in cardiovascular regulatory mechanisms or underlying pathological conditions and may represent a source of damage to the cardiovascular system. The clinical significance and prognostic implications of these BP variations have been demonstrated by a series of clinical and population studies conducted in recent years, in which increasing BPV has been associated with a higher risk of subclinical organ damage, cardiovascular events, and cardiovascular and all-cause mortality, independent of elevated average BP values. This paper will review the available evidence on the current definitions, classification, and mechanisms responsible for different types of BPV by focusing on their relevance to cardiovascular homeostasis and cardiovascular disease.

中文翻译：

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血压变异性：其与心血管稳态和心血管疾病的相关性

血压 (BP) 是临床实践中常规测量的最具动态的生理变量之一，其特征是逐次、超过 24 小时、每日和逐次检查的连续和显着变化. 在生理条件下，这些血压变化在很大程度上代表了对环境刺激和日常生活挑战的反应，旨在维持所谓的心血管“稳态”。然而，血压变异性 (BPV) 的持续增加也可能反映了心血管调节机制或潜在病理状况的改变，并且可能是心血管系统损伤的一个来源。近年来进行的一系列临床和人群研究已经证明了这些血压变异的临床意义和预后意义，其中，BPV 增加与亚临床器官损伤、心血管事件以及心血管和全因死亡率的较高风险相关，而与平均血压值升高无关。本文将通过关注与心血管稳态和心血管疾病的相关性，回顾有关当前定义、分类和负责不同类型 BPV 的机制的现有证据。