Researchers at Imperial College London have identified a link between unstable blood pressure and an elevated risk of heart attack and stroke. The findings, published in the European Heart Journal, highlight how blood pressure that fluctuates over time may be a significant predictor of cardiovascular events.
In a long-term observational study, more than 8,000 British adults diagnosed with high blood pressure were tracked for two decades. The investigation showed that not only the average systolic pressure but also its variability—the degree to which systolic readings swing from visit to visit—are important factors in determining future risk. These fluctuations can worsen the likelihood of stroke, heart attack, and episodes of atrial fibrillation as people age, underscoring the need to monitor stability as well as level when managing blood pressure.
Participants were categorized according to their average systolic pressure and the extent of its variability. Among those whose mean systolic blood pressure remained below 140 millimeters of mercury, individuals with higher variability demonstrated a notably increased risk of cardiovascular events compared with peers who showed lower variability. The data suggest that greater fluctuations in pressure, even within ranges commonly considered acceptable, may translate into meaningful rises in risk over time.
Researchers note that pressure swings within what is generally regarded as normal can still be associated with adverse outcomes. In particular, variations in systolic readings of about 13 millimeters of mercury or more over a five-year span were linked to a higher probability of developing heart and brain vascular issues. The study emphasizes that stability in blood pressure could be as important as reaching a target level, with larger swings presenting a persistent challenge to vascular health across the population.
Overall, the study contributes to a growing body of evidence that identifies blood pressure variability as a distinct risk factor for stroke and other cardiovascular problems. The implications extend to clinical practice, where clinicians may place greater emphasis on therapies and lifestyle adjustments that reduce day-to-day and visit-to-visit fluctuations. By focusing on consistent blood pressure control, patients may improve long-term outcomes and lower their chance of experiencing serious cardiac or cerebrovascular events.