Blood pressure variability could predict heart attack and stroke

Changes to blood pressure over time could be used to identify patients at greatest risk of heart attack and stroke, according to a study led by researchers at Imperial College London and published in the European Heart Journal.

It reveals that patients whose blood pressure varies significantly from one doctor’s visit to another  may be at greater risk of heart attack and stroke, compared to those with high blood pressure but low variability, and that is controlled by medication.

Large analysis

The researchers analysed data from the ASCOT study, which has followed over 8,000 UK patients with high blood pressure for more than 20 years.

Their analysis revealed that variation in systolic pressure (the larger of the two numbers used to measure blood pressure) was a predictor of stroke, heart attack and atrial fibrillation. High variability of blood pressure was also a strong predictor of risk at all levels of average blood pressure, whether low or high.

The team behind the study are calling for medical guidelines to be changed to focus not only on the measurement of a patient's blood pressure but how it varies from visit to visit in order to intervene earlier and reduce risk.

The researchers also highlight that data from the trial show that one blood pressure medication, a drug called amlodipine, was effective in lowering blood pressure variability and could help to reduce risk.

Our comment

Bryan Williams, our Chief Scientific and Medical Officer said: “These findings once again shed light on the predictive significance of blood pressure variability for the risk of heart attack and stroke.

“The study suggests that monitoring blood pressure variability could be a vital addition to routine health checks, helping to spot patients who remain at risk despite appearing to have well-controlled blood pressure.

“The challenge identified by this study for the future, is how to reduce blood pressure variability and smooth the blood pressure profile, beyond the lowering of blood pressure itself which we know is protective against heart attack and stroke.

“An estimated 30 per cent of adults in the UK have high blood pressure, which is around 16 million adults. Getting your blood pressure checked and treated if its elevated is one of the most important things you can do to prevent heart attack and stroke and help save lives.”