Scientists have linked blood pressure readings with the risk of stroke and death

Changes in blood pressure between medical examinations were associated with an increased risk of death and stroke. Researchers from the Netherlands came to this conclusion after analyzing the data of 57,611 participants. About why not only average pressure values are important, see the Izvestia article.

Pressure fluctuations were associated with the risk of death

The researchers examined data from 57,611 participants whose blood pressure was measured during the initial examination and at least one more follow-up visit. The average age of the participants was 55.4 years, 52% of them were women. The study was led by Dr. Fariba Ahmadizar from the Department of General Medical Practice at the University of Amsterdam Medical Center. The work was published in the journal Medical Xpress.

The researchers assessed how much four indicators changed between visits: systolic and diastolic blood pressure, average blood pressure and pulse pressure. The time between measurements was taken into account.

During the median follow-up period of 5.1 years, 1,460 participants died. Higher variability in each of the four indicators was associated with an increased risk of death from any cause. The relationship persisted even after taking into account the average blood pressure level, blood sugar status, and other factors.

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Pressure changes have been linked to stroke

The most pronounced associations with stroke were found for the variability of diastolic and mean blood pressure. During the follow-up, 571 participants had a stroke.

Each increase in diastolic pressure variability by one standard deviation was associated with a 12% increased chance of stroke. For the average blood pressure, the same indicator was 10%.

At the same time, the researchers separately emphasized that the standard deviation reflects differences in blood pressure variability between participants. Therefore, the percentages obtained cannot be directly translated into a specific pressure change in millimeters of mercury.

The researchers did not find a statistically significant association between blood pressure variability and the development of dementia: during the follow-up period, it was diagnosed in 319 participants.

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Diabetes has increased the link with the risk of death

The researchers also compared blood pressure variability with blood sugar levels. At the beginning of the study, 50,744 participants had normal blood sugar levels, 5,397 had prediabetes, and 1,470 had type 2 diabetes.

The most noticeable difference was observed in people with type 2 diabetes and high systolic pressure variability. Compared with participants with normal sugar levels and low systolic pressure variability, the risk of death in this group was 2.8 times higher.

Among participants with prediabetes and high systolic blood pressure variability, the risk of death was 62% higher compared to the group with normal blood sugar levels and low blood pressure variability.

The authors note that such comparisons simultaneously take into account two factors — the state of blood sugar and pressure variability. Therefore, the difference cannot be explained solely by changes in blood pressure.

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Scientists have suggested taking into account not only the average pressure

Blood pressure variability is not yet one of the indicators that are usually taken into account when assessing a person's condition along with the average blood pressure level. The new data shows that changes in indicators between surveys may contain additional information about risks. In this case, we are not talking about a single pressure surge, but about differences between measurements over time. The researchers assessed the degree of variability of the indicators between the visits of the participants.

According to Ahmadizar, pressure changes over time can provide information that is insufficient when using only averages. However, the authors consider further studies necessary before pressure variability can be recommended for regular assessment.

The study does not prove a causal relationship

The results show a statistical relationship between blood pressure variability and the risk of death or stroke, but they do not prove that it is pressure fluctuations that cause these events.

The study was observational in nature, so scientists could not establish a cause-and-effect relationship. In addition, the question remains whether it is possible to reduce the identified risks by reducing blood pressure variability.

The authors note that additional research is needed for this. In particular, it remains to be seen whether it is possible to purposefully reduce pressure fluctuations and whether this will lead to a lower risk of stroke or death.