Hypertension patients whose blood pressure readings vary significantly could be at greater risk of heart attack and stroke than those whose high blood pressure is stable.
Imperial College London (ICL) researchers analysed data from a 20-year study of more than 8,000 UK hypertension patients who were on medication to control their blood pressure to reach their findings.
Clinical practice, based on current guidelines, says treatment decisions in patients with hypertension are determined by levels of systolic and diastolic blood pressure – the higher and lower numbers of blood pressure readings respectively.
‘Our studies, however, provide robust evidence that visit-to-visit blood pressure variability is a far more powerful determinant of cardiovascular outcome and that at least half of all cardiovascular events in our cohort occurred in those with controlled blood pressure but high blood pressure variability,’ the paper published in the European Heart Journal said.
As a result, the researchers have called for medical guidelines to be changed to take into account interventions where a patient’s blood pressure varies between readings.
The ICL team also highlighted that the drug amlodipine proved effective in lowering blood pressure variability during trials and could help to reduce risk.
Bryan Williams, chief scientific and medical officer at the British Heart Foundation, said: ‘The study suggests that monitoring blood pressure variability could be a vital addition to routine health checks, helping to spot patients who remain at risk despite appearing to have well-controlled blood pressure.
‘The challenge identified by this study for the future, is how to reduce blood pressure variability and smooth the blood pressure profile, beyond the lowering of blood pressure itself which we know is protective against heart attack and stroke.’
Last month, a study reported that attending an NHS Health Check is associated with a lower risk of both death and several diseases.
The observational study using UK Biobank participants found that among those who took up an NHS Health check there was a 19% lower rate of dementia diagnosis and 23% lower risk of death from any cause.
A version of this article was first published by Pulse’s sister title The Pharmacist
