Is Blood Pressure Variability a Sign of Increased Cardiovascular Risk?

Visit-to-visit variability (VVV) of systolic blood pressure is associated with an increased risk of cardiovascular disease (CVD) and mortality, according to a recent study.

In order to examine whether VVV of systolic and diastolic blood pressure influenced risk of CVD and mortality, researchers conducted a prospective cohort study of 25,814 individuals with hypertension. Participants’ blood pressure levels were measured at 7 visits between 6 and 28 months after enrolling in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
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Those participants who did not experience adverse cardiovascular events during the 28 months of follow-up continued to be followed during the remainder of active ALLHAT follow-up (up to 5.7 additional years).

Overall, 1194 coronary heart disease or myocardial infarction events, 1948 deaths, 606 strokes, and 921 heart failure events occurred during follow-up.

Those participants with the highest VVV of systolic blood pressure (≥ 14.4 mm Hg) had significantly higher risk of CVD or death than those with the lowest VVV of systolic blood pressure (<6.5 mm Hg). Higher VVV of diastolic blood pressure was also associated with increased risk of CVD and mortality.

“Higher VVV of systolic blood pressure is associated with an increased risk for CVD and mortality,” the researchers concluded.  

“Future studies should examine whether reducing VVV of blood pressure lowers this risk.”

—Michael Potts

Reference:

Muntner P, Whittle J, Lynch AI, et al. Visit-to-visit variability of blood pressure and coronary heart disease, stroke, heart failure, and mortality: a cohort study. Ann Intern Med. July 2015 [epub ahead of print]. doi:10.7326/M14-2803.