A new study from the ASCOT study, led by researchers from Imperial College London and published in the European Heart Journal, shows that variations in blood pressure over time may predict the risk of heart attack and stroke.
This finding suggests that patients with big fluctuations in blood pressure could face a higher risk of heart disease than those with consistently high blood pressure managed with medication.
The study tested over 8,000 UK patients with high blood pressure for more than 20 years.
It was found that variability in systolic pressure (the higher number in a blood pressure reading) is a strong predictor of major cardiovascular events such as stroke, heart attack, and atrial fibrillation.
Interestingly, this high variability was a big predictor of risk across all levels of average blood pressure, from low to high.
The researchers suggest a change in medical guidelines to emphasize not just the measurement of a patient’s blood pressure but also its variation over time.
This approach could enable earlier interventions and potentially reduce the risk of cardiovascular events.
A key takeaway from the trial data is that the blood pressure medication amlodipine effectively lowers blood pressure variability.
Professor Peter Sever, the study’s senior author, highlights the importance of considering blood pressure variability alongside high blood pressure as a risk factor.
He notes that while doctors are aware of this variability, quantifying its long-term risk and the impact of interventions like calcium blockers has been challenging without clinical trials.
Hypertension, or high blood pressure, is a leading global health concern, contributing to a significant number of strokes and heart attacks.
With new definitions categorizing hypertension as blood pressure over 130/80 mmHg, nearly half of all adults are affected.
Although the condition can be controlled with medications, the findings from this study suggest that managing blood pressure variability could be equally crucial.
Ambulatory blood pressure monitoring, which tracks average blood pressure over a 24-hour period, is a common practice but does not account for longer-term variability.
Professor Sever emphasizes the potential of incorporating data from home blood pressure monitoring into clinical decisions, considering the widespread availability of digital blood pressure monitors and health apps.
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The research findings can be found in the European Heart Journal.
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