Visit-to-visit systolic blood pressure variability is associated with increased fatigue symptoms in multiple sclerosis patients

Objective: To evaluate the relationship between visit-to-visit systolic blood pressure variability (SBPv) and fatigue symptoms in Multiple Sclerosis (MS) patients. Methods: This is a cross-sectional study using data for MS patients who completed the Fatigue Subscale in the Performance Scales (PS), a validated, self-reported measure of MS-related disability, between 2011 and 2015 at an academic medical center. Those who had at least 3 available SBP measures within the prior 12 months of the survey were included in the analysis. Ordinal logistic regression was used to model fatigue as a function of SBP variability, adjusting for demographic factors and mean SBP. Results: Data for 91 MS subjects were analyzed. We found that, compared to those with the lowest SBP variability (Tertile 1), subjects in Tertile 2 had 2.2 times higher odds (OR = 2.19; 95% CI, 0.82–5.87; p = 0.120) and those in Tertile 3 (highest variability) 4.2 times higher odds (OR = 4.16; 95% CI, 1.56–11.13; p = 0.005) of being in a higher fatigue level group, independent of age, sex, race/ethnicity, and mean SBP. Conclusions: Our data show that MS patients with higher SBP variability had a greater degree of fatigue. Future research is needed to further explore this relationship and the potential for therapeutic opportunities to improve fatigue.