Lifestyle modification factors in hypertensive patients: impact on blood pressure variability

  • N. Ya. Dotsenko State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
  • S. S. Boev State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
  • I. A. Shekhunova State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
  • L. V. Нerasуmenko State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
  • A. V. Molodan State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
  • A. Ya. Malinovskaya State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
Keywords: arterial hypertension, blood pressure variability, lifestyle


Current guidelines do not suggest considering blood pressure variability in the management of hypertensive patients. At the same time, a sufficient evidence base has been accumulated on the relationship of blood pressure variability with damage to target organs, the development of stroke, myocardial infarction, cardiovascular mortality, and kidney disease. In general, assessing the effect of blood pressure variability on the course of arterial hypertension, it can be assumed that it is not as significant as the absolute values of blood pressure, but this effect has been proven, regardless of the degree of hypertension. And if a practitioner finds an increased variability in blood pressure in his patient, he should know what recommendations should be given to him.

Not all traditional lifestyle modification factors that are suggested for hypertensive patients affect blood pressure variability in the same way as blood pressure readings. Thus, we were unable to find evidence of the influence of increased consumption of table salt, physical activity, «chronic psychological stress» on the variability of blood pressure in the general population. At the same time, dietary habits, alcohol abuse, smoking status affect the level of blood pressure, blood pressure variability in both healthy individuals and patients with arterial hypertension. The same effect is exerted by the relative intake of minerals with food, toxic agents (lead). If in individuals of the general population an increase in body weight leads to an increase in blood pressure, then in patients with arterial hypertension such an effect is nonlinear, depending on the type of obesity. It should be emphasized once again that the presence of psychoemotional disorders symptoms of anxiety, depression – in patients with arterial hypertension contributes both to an increase in the level of blood pressure, but also to its variability.


Mehlum M.H., Liestоl K, Kjeldsen S.E. et al. Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks. Eur. Heart J. 2018: 39 (24); 2243–2251. doi: 10.1093/eurheartj/ehx760.

Palatini P, Saladini F, Mos L et al. Shortterm blood pressure variability outweighs average 24h blood pressure in the prediction of cardiovascular events in hypertension of the young. J. Hypertens. 2019; 37 (7): 1419–1426. doi: 10.1097/HJH.0000000000002074.

Nardin C, Rattazzi M, Pauletto P Blood Pressure Variability and Therapeutic Implications in Hypertension and Cardiovascular Diseases. High Blood Press Cardiovasc. Prev. 2019; 26 (5): 353–359.

Rekovets O.L., Torbas O.O., Kushnir S.M. et al. Time of angiotensin II receptor blockers and their antihypertensive effect: own experience of chronotherapy. Arterial'naja gipertenzija. 2020; 13 (4): 5–18. http://dx.doi. org/10.22141/2224–1485.13.4.2020.211954.

Migdal K.U., Babcock M.C., Robinson A.T. et al. The Impact of High Dietary Sodium Consumption on Blood Pressure Variability in Healthy, Young Adults. Am. J. .Hypertension. 2020;33(5): 422–429.

Omboni S Does Dietary Salt Loading Impair Ambulatory Blood Pressure Variability? As Yet an Unresolved Issue. Am. J. Hypertension. 2020; 33 (5): 405–406.

Iuchi H, Sakamoto M, Suzuki H Effect of OneWeek Salt Restriction on Blood Pressure Variability in Hypertensive Patients with Type 2 Diabetes. DOI: 10.1371/journal. pone.0144921Corpus ID: 6239118.

Ozkayar N, Dede F, Ates Ietal. Therelationship between dietary salt intake and ambulatory blood pressure variability in nondiabetic hypertensive patients. Nefrologia. 2016; 36 (6): 694–700. doi: 10.1016/j.nefro.2015.12.004.

Chi W, TongBo L., Lei M et al. Association between dietary sodium intake and blood pressure variability in Chinese patients with hypertension. Medical. Journal. 2020; 133 (9): 1066–1072. doi: 10.1097/CM9.0000000000000740.

Jaubert MP, Jin Z, Russo C et al. Alcohol Consumption and Ambulatory Blood Pressure: A CommunityBased Study in an Elderly Cohort. Am. J. Hypertens. 2014; 27(5): 688–694. doi: 10.1093/ajh/hpt235.

Nakashita M, Ohkubo T, Hara A et al. Influence of Alcohol Intake on Circadian Blood Pressure Variation in Japanese Men: The Ohasama Study. Am. J. Hypertension. 2009; 22 (11): 1171–1176.

Hillbom M, Saloheimo P, Juvela S Alcohol Consumption, Blood Pressure, and the Risk of Stroke. Curr. Hypertens Rep. 2011. 13 (3): 208–213.

Maseli A, Aeschbacher S, Schoen T et al. Healthy Lifestyle and Blood Pressure Variability in Young Adults. Am. J. Hypertension. 2017; 30 (7); 690–699.

Lau KK, Wong YK, Chan YH et al. MediterraneanStyle Diet Is Associated With Reduced Blood Pressure Variability and Subsequent Stroke Risk in Patients With Coronary Artery Disease. Am. J. Hypertension. 2015; 28 (4): 501–507.

Umemoto S, Onaka U, Kawano R et al. Effects of a Japanese CuisineBased Antihypertensive Diet and Fish Oil on Blood Pressure and Its Variability in Participants with Untreated Normal High Blood Pressure or Stage I Hypertension: A Feasibility Randomized Controlled Study. J. Atherosclerosis and Thrombosis. 2020.

Siervo M, Lara J, Jajja A et al. Ageing modifies the effects of beetroot juice supplementation on 24hour blood pressure variability: An individual participant meta analysis. Nitric Oxide. 2015; 47: 97–105. https://

Weaver C.M,, Bailey R.L, McCabe LD et al. Mineral Intake Ratios Are a Weak but Significant Factor in Blood Pressure Variability in US Adults. Journal of Nutrition. 2018. 148 (11): 1845–1851.

Erdem Y, Özkan G, Ulusoy Ş et al. The effect of intermittent fasting on blood pressure variability in patients with newly diagnosed hypertension or prehypertension. J. American Society of Hypertension . 2018; 12 (1): 42–49.

Faramawi M.F., Delongchamp R., Lin Y.S. et al. Environmental lead exposure is associated with visittovisit systolic blood pressure variability in the US adults. Int. Arch. Occup. Environ. Health. 2015; 88: 381–388. https://doi. org/10.1007/s0042001409705.

Faramawi M.F., Fischbach L, Delongchamp R et al. Obesity is associated with visittovisit systolic blood pressure variability in the US adults. J. Public Health. 2015; 37 (4): 694–700. https://

Chen H, Chen Y, Wu W et al. Effect of visittovisit blood pressure variability on cardiovascular events in populations with different body mass indexes: a prospective cohort study. B.M.J. 2020;10:e035836. doi: 10.1136/bmjopen2019035836.

Chen H, Zhang R, Zheng Q et al. Impact of body mass index on longterm blood pressure variability: a crosssectional study in a cohort of Chinese adults. BMC Public Health. 2018. https://

Yano Y, Vongpatanasin W, Ayers C et al. Regional Fat Distribution and Blood Pressure Level and Variability. The Dallas Heart Study. Hypertension. 2016; 68: 576–583 https://doi. org/10.1161/HYPERTENSIONAHA.116.07876.

Kovaleva O.N., Sitina І.В. Features of the parameters of daily blood pressure monitoring in patients with comorbidity of obesity and hypertension. Mezhdunarodnyj jendokrinologicheskij zhurnal. 2013; 5 (53): 21–25.

Tadic M, Cuspidi C, Pencic B et al. The interaction between blood pressure variability, obesity, and left ventricular mechanics. J. Hypertension. 2016; 34 (4): 772–780. doi: 10.1097/HJH.0000000000000830.

Hashimoto Y., Kaji A., Sakai R. et al. Sarcopenia is associated with blood pressure variability in older patients with type 2 diabetes: A crosssectional study of the KAMOGAWADM cohort study. Geriatr. Gerontol. Int. 2018; 18 (9): 1345–1349. doi: 10.1111/ggi.13487.

Gechko M.M., Chubirko K.I., Chopey I.V. Indicators of monitoring arterial grip in patients from overexcess weight and obesity with reduction of muscle mass Ukraine. Zdorov’ja nacії. 2016; 1–2: 48–53.

Lin GM, Tsai KZ, Lin CS Physical Fitness and Longterm Blood Pressure Variability in Young Male Military Personnel. Curr. Hypertens. Rev. 2020; 16 (2): 156 – 160. DOI: 10.2174/1573402115666191023111351.

Leary A.C., Donnan P.T., MacDonald ThM et al. The influence of physical activity on the variability of ambulatory blood pressure. American J. Hypertension. 2000; 13(10): 1067–1073.

Pagonas N, Dimeo F, Bauer F et al. The impact of aerobic exercise on blood pressure variability. J. Human Hypertension. 2014; 28: 367–371. doi:10.1038/jhh.2013.121.

Melnik O Modification of the additional rhythm of the arterial clutch and endogenous factors in the development of hypertensive ailments due to physical rehabilitation in young people. Sportivnij vіsnik Pridnіprov'ja. 2015; 1: 162–166.

Ivanko O.G., Mikhalyuk E.L., Lyakhova I.M. et al. Possibilities and limitations of physical therapy in adolescents with arterial hypertension. Ukraїns'kij zhurnal medicini, bіologії ta sportu. 2020; 3 (25): 359–365. DOI: 10.26693/jmbs05.03.359.

Bolinder G, Faire U de Ambulatory 24h Blood Pressure Monitoring in Healthy, Middle Aged Smokeless Tobacco Users, Smokers, and Nontobacco Users. Am. J. Hypertension. 1998; 11 (10): 1153–1163. S08957061(98)00137X.

Weaver C.M., Bailey R.L., McCabe L.D. et al. Mineral Intake Ratios Are a Weak but Significant Factor in Blood Pressure Variability in US Adults. Journal Nutrition. 2018; 148 (11): 1845–1851.

Hashimoto T, Kikuya M, Ohkubo T et al. Home Blood Pressure Level, Blood Pressure Variability, Smoking, and Stroke Risk in Japanese Men: The Ohasama Study. Am. J. .Hypertension. 2012; 25 (8): 883–891.

Lin YP, Fan CH, Tsai KZetal. Psychological stress and longterm blood pressure variability of military young males: The cardiorespiratory fitness and hospitalization events in armed forces study. World J. Cardiol. 2020; 12 (12): 626–633. doi: 10.4330/wjc.v12.i12.626.

Tully P.J., Tzourio C Psychiatric correlates of blood pressure variability in the elderly: The Three City cohort study. Physiology & Behavior. 2017; 168: 91–97.

Shin S.M., Shim W.J., Park S.M. Early changes of left ventricular function in young adults with nevertreated hypertension and no left ventricular hypertrophy:relationships to ambulatory blood pressure monitoring. Clin Exp Hypertens. 2014. 36 (7). 517–523. doi: 10.3109/10641963.2013.863326.

Kayano H., Koba S., Matsui T. et al. Impact of depression on masked hypertension and variability in home blood pressure in treated hypertensive patients. Hypertens. Res. 2015; 38: 751–757.

Tully P.J., Debette S, Tzourio C The association between systolic blood pressure variability with depression, cognitive decline and white matter hyperintensities: the 3C Dijon MRI study. Psychol. Med. 2018; 48(9): 1444–1453. doi: 10.1017/S0033291717002756.

Solomenchuk T.M., Vosukh O.V. Correction of neurohumoral and psychoemotional disorders in patients with stable coronary heart disease and hypertension: adaptive capabilities of the drug Noofen®. Semejnaja medicina. 2018; 1: 58–68.

Kovalchuk T.A., Boyarchuk O.R. Features of the circadian rhythm of blood pressure in children with vasovagal syncope. Aktual'nі pitannja pedіatrії, akusherstva ta gіnekologії. 2020; 1: 10–16.

Li N., Chen G., Liu F. et al. Associations between longterm exposure to air pollution and blood pressure and effect modifications by behavioral factors. Environ. Res. 2020; 182.

Choi Y.J., Kim S.H., Kang H et al. Short term effects of air pollution on blood pressure. Sci. Rep. 2019. s4159801956413y.

How to Cite
Dotsenko, N. Y., Boev, S. S., Shekhunova, I. A., НerasуmenkoL. V., Molodan, A. V., & Malinovskaya , A. Y. (2021). Lifestyle modification factors in hypertensive patients: impact on blood pressure variability. Modern Medical Technology, (2(49), 37-42.
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