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Background <p>Spinal cord injury (SCI) at or above the sixth thoracic spinal cord segment can disrupt autonomic cardiovascular control, leading to increased BP variability (BPV). This study compared BPV, nocturnal dipping patterns, and blood pressure (BP) fluctuations among individuals with cervical SCI (C-SCI), upper-thoracic SCI (UT-SCI), and non-injured controls (NI-C).</p> Methods <p>Using 24-h ambulatory blood pressure monitoring, we analyzed BPV (via standard deviation [SD], coefficient of variation [CoV], average real variability [ARV], and variability independent of the mean [VIM]), nocturnal dipping, and systolic/diastolic BP fluctuations. Nocturnal dipping percentages were calculated and patterns classified. Hypotensive (SBP &lt; 100 mmHg, DBP &lt; 70 mmHg) and hypertensive (SBP &gt; 150 mmHg per clinical guideline thresholds) events were identified. BP distribution was analyzed using skewness and kurtosis.</p> Results <p>Eighty participants (44 C-SCI, 19 UT-SCI, 17 NI-C) had 66 ± 18 measurements taken and are included in the analysis. Overall 24-h BP levels were lower in the SCI groups than in NI-C. The C-SCI group exhibited significantly higher systolic BPV metrics across SD, CoV, ARV, and VIM compared to the UT-SCI and NI-C groups (<i>P</i> &lt; 0.01). C-SCI nocturnal BP dips were reduced, and reverse dipping patterns were more prevalent (<i>P</i> &lt; 0.001). A nadir-based trough nocturnal dipping analysis suggested reduced nighttime BP decline in C-SCI (<i>P</i> &lt; 0.001). Hypotensive events occurred more frequently in C-SCI and UT-SCI compared to NI-C (both <i>P</i> &lt; 0.001).</p> Conclusion <p>Individuals with C-SCI showed significantly increased BPV and impaired nocturnal dipping, while both C-SCI and UT-SCI demonstrated heightened susceptibility to hypotensive events. These findings highlight the need for targeted cardiovascular monitoring and interventions in individuals with C-SCI and UT-SCI to mitigate the known risks associated with BP dysregulation.</p>

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Blood pressure variability in daily life: comparing individuals with cervical and upper-thoracic spinal cord injury to non-injured controls

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月9日

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  • Shane J. T. Balthazaar,
  • Matthias Walter,
  • Catherine R. Jutzeler,
  • Andrea L. Maharaj,
  • Andrei V. Krassioukov,
  • Tom E. Nightingale

摘要

Background

Spinal cord injury (SCI) at or above the sixth thoracic spinal cord segment can disrupt autonomic cardiovascular control, leading to increased BP variability (BPV). This study compared BPV, nocturnal dipping patterns, and blood pressure (BP) fluctuations among individuals with cervical SCI (C-SCI), upper-thoracic SCI (UT-SCI), and non-injured controls (NI-C).

Methods

Using 24-h ambulatory blood pressure monitoring, we analyzed BPV (via standard deviation [SD], coefficient of variation [CoV], average real variability [ARV], and variability independent of the mean [VIM]), nocturnal dipping, and systolic/diastolic BP fluctuations. Nocturnal dipping percentages were calculated and patterns classified. Hypotensive (SBP < 100 mmHg, DBP < 70 mmHg) and hypertensive (SBP > 150 mmHg per clinical guideline thresholds) events were identified. BP distribution was analyzed using skewness and kurtosis.

Results

Eighty participants (44 C-SCI, 19 UT-SCI, 17 NI-C) had 66 ± 18 measurements taken and are included in the analysis. Overall 24-h BP levels were lower in the SCI groups than in NI-C. The C-SCI group exhibited significantly higher systolic BPV metrics across SD, CoV, ARV, and VIM compared to the UT-SCI and NI-C groups (P < 0.01). C-SCI nocturnal BP dips were reduced, and reverse dipping patterns were more prevalent (P < 0.001). A nadir-based trough nocturnal dipping analysis suggested reduced nighttime BP decline in C-SCI (P < 0.001). Hypotensive events occurred more frequently in C-SCI and UT-SCI compared to NI-C (both P < 0.001).

Conclusion

Individuals with C-SCI showed significantly increased BPV and impaired nocturnal dipping, while both C-SCI and UT-SCI demonstrated heightened susceptibility to hypotensive events. These findings highlight the need for targeted cardiovascular monitoring and interventions in individuals with C-SCI and UT-SCI to mitigate the known risks associated with BP dysregulation.