Abstract
The hypertensive microvascular disorder is a significant complication that can lead to substantial target organ damages, including cognitive impairments, visual impairments, and deterioration in renal function. Recent studies have indicated that blood pressure variability (BPV) is an independent risk factor for the progression of this pathology. The present paper aims to systematically elucidate the concept, classification, and clinical significance of BPV, focusing on how it acts as a pathogenic mechanism independent of mean blood pressure to exacerbate endothelial injury and cause target organ damage. This review was conducted to evaluate the influences of multiple factors on BPV, including neurohumoral regulation, the behavioural environment and comorbidities. It also emphasises the intrinsic link between BPV and microvascular complication risk in specific populations, such as those with diabetes and obesity. In summary, it is evident that a comprehensive exploration of the underlying mechanisms of BPV is imperative for the early prevention and treatment of hypertensive microvascular diseases.