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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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats: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\u2009&lt;\u2009100\u2009mmHg, DBP\u2009&lt;\u200970\u2009mmHg) and hypertensive (SBP\u2009&gt;\u2009150\u2009mmHg per clinical guideline thresholds) events were identified. BP distribution was analyzed using skewness and kurtosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty participants (44 C-SCI, 19 UT-SCI, 17 NI-C) had 66\u2009\u00b1\u200918 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 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). C-SCI nocturnal BP dips were reduced, and reverse dipping patterns were more prevalent (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). A nadir-based trough nocturnal dipping analysis suggested reduced nighttime BP decline in C-SCI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Hypotensive events occurred more frequently in C-SCI and UT-SCI compared to NI-C (both\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41371-026-01179-w","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:39:15Z","timestamp":1783615155000},"page":"712-723","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Blood pressure variability in daily life: comparing individuals with cervical and upper-thoracic spinal cord injury to non-injured controls"],"prefix":"10.1038","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8860-2898","authenticated-orcid":false,"given":"Shane J. 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Ethical approval for this study was obtained and details of each study are provided in Supplementary Table\u00a0\n                      \n                      . All participants provided informed consent prior to participation.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"SJTB has received compensation from Sanofi Genzyme, a division of Sanofi-Aventis Canada Inc., as a scientific expert for a preceptorship program between 2021 and 2023; however, this role had no influence on the design, conduct, or reporting of this study. MW served as a consultant to Coloplast between 2022 and 2024; however, this role had no influence on the design, conduct, or reporting of this study. CRJ serves as a scientific consultant to Abbvie and Mitsubishi Takeda; however, this role had no influence on the design, conduct, or reporting of this study. AVK has received personal compensation for serving on a Scientific Advisory or Data Safety Monitoring board for ONWARD Medical Inc; however, this role had no influence on the design, conduct, or reporting of this study.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}