Introduction: The prognostic impact of each determinant of blood pressure (BP) profile s uch a s s ystolic BP, d iastolic BP, p ulse p ressure ( PP), BP v ariability (BPV) was essentially studied in patients with hypertension, but there is a lack of data in patients with HFpEF. The aim of the present study was to assess the correlation of short-term BPV with intrarenal hemodynamics (IRH) in HFpEF. Methods: The research included 60 patients with HFpEF aged 18-79 years, the mean age being of 50.15 ± 14.50 years, whereas 53% (32 pts) were men and 47% (28 pts) were women. All subjects underwent careful clinical history and physical examination to reveal risk factors, cardiovascular history and treatments. Echocardiography, 24-hours ambulatory blood pressure monitoring (ABPM) (with the evaluation of the nictimeral blood pressure variability patterns), intrarenal Doppler ultrasound, obtaining the following IRH parameters: renal resistive index (RRI), renal pulsatile index (RPI), acceleration time (AT), renal volume (RV) and RV/RRI ratio. Results: The analysis of BP values showed that 22% (13 pts) had stage I HTN, 48% (29 pts) - stage II HTN and 30% ( 18 pts) – stage III HTN , whereas the mean age of HTN onset was 40.55 ± 10.27 years, the mean HTN duration being of 9.57 ± 7.12 years, mean ejection fraction 56 ± 4.562%, mean NT-proBNP levels 654 ± 93 pg/ml. The study of nictemeral HTN patterns revealed four major phenotypes: dipper, non-dipper, reverse-dipper and extreme-dipper. according to SBP data, 2% of the studied population were assessed as night-peakers, 47.5%- non-dippers, 47% were dippers and 3.5 % - extreme dippers. The analysis of DBP variations included 1.5% of night-peakers, 46.5% - non-dippers, 40.5% - dippers and 11.5% of patients were assessed as extreme dippers. The comparative analysis of nictemeral SBP and DBP variations with IRH parameters revealed that IRH parameter changes depend upon the detected HTN pattern. Thus, RRI recorded the highest values in night-peakers (0.68 ± 0.0452), followed by non-dippers (0.674 ± 0.0373), dippers (0.662 ± 0.0321), whereas the lowest being in extreme dippers (0.642 ± 0.0256), p < 0.01). Similar correlations were assessed for RPI (1.29 ± 0.06 vs. 1.26 ± 0.02 vs. 1.23 ± 0.02 vs. 1.27 ± 0.09 , p < 0.05) and AT (67.87 ± 0.13 vs. 66.54 ± 0.26 vs. 66.82 ± 0.27 vs. 65.86 ± 1.03, p < 0.05) with the highest values of RPI in night peakers and the lowest values for dippers, whereas the RV (124.67 ± 16.18 vs. 129.93 ± 2.43 vs. 127.73 ± 2.69 vs. 150.00 ± 10.97, p < 0.05) and VR/RRI ratio revealed the lowest values in night-peakers and the highest in extreme-dippers. Conclusions: IRH and ABPM, as well as their tight connection, proved their importance as useful and multifunctional tools that could provide a deeper insight into cardiovascular continuum, overall cardiovascular risk and renal involvement in the not only in the context of a hypertensive patient, but also in the setting of a patient with HFpEF.