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Variation in Blood Pressure Readings and the Risk for Cardiovascular Disease FREE

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The full report is titled “Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality. A Cohort Study.” It is in the 1 September 2015 issue of Annals of Internal Medicine (volume 163, pages 329-338). The authors are P. Muntner, J. Whittle, A.I. Lynch, L.D. Colantonio, L.M. Simpson, P.T. Einhorn, E.B. Levitan, P.K. Whelton, W.C. Cushman, G.T. Louis, B.R. Davis, and S. Oparil.

This article was published online first at www.annals.org on 28 July 2015.

Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.

Ann Intern Med. 2015;163(5):I-27. doi:10.7326/P15-9027
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What is the problem and what is known about it so far?

High blood pressure (BP) increases the risk for heart disease; heart attacks; and other cardiovascular problems, such as stroke. A patient's BP is usually determined by measurements made at a few visits to a physician's office. Variation that might occur in a patient's BP readings over many more visits, however, is often disregarded as less important. Whether such variation is indeed unimportant is not known.

Why did the researchers do this particular study?

To find out if greater variation in BP readings over many visits is associated with an increased risk for cardiovascular disease or death.

Who was studied?

25 814 study participants with high BP aged 55 years or older who were already enrolled in a study of different BP medicines.

How was the study done?

The researchers first measured the participants' BP at 7 visits that were spread out over 22 months to determine how much variability there was. Then, the participants were followed until the end of the study (follow-up was 2.8 years on average) to see who developed cardiovascular disease (including heart attacks and strokes) or died. Researchers assessed if participants who developed cardiovascular disease or died had greater variability in their BP readings.

What did the researchers find?

The greater the variability in a participant's BP readings before the follow-up period, the more likely the participant was to have had a poor health outcome, including fatal or nonfatal heart attack, stroke, or death, due to cardiovascular or other causes.

What were the limitations of the study?

The study cannot determine whether greater variability in BP caused the poor health outcomes or whether this variability is something that happens to be seen in patients more likely to have these outcomes due to other causes.

What are the implications of the study?

More studies are needed to see if lowering variability in BP readings can reduce the risk for cardiovascular disease or death.





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