Visit-to-Visit Blood-Pressure Variability May Predict CV Risk
Written by Editor   
Tuesday, August 11, 2015 12:00 AM

Research is beginning to indicate that moderate blood pressure fluctuations over several office visits may indicate an increased risk of cardiovascular issues.  Variations in visit-to-visit blood-pressure readings can help identify high-risk patients.

Hypertensive patients with significant changes in blood-pressure readings over several office visits had an increased risk of stroke, MI, heart failure, and death during a 2.8-year follow-up—independent of how well their hypertension was controlled—in a new study.

Variability in office blood-pressure readings is not the same as the normal 24-hour or stress-related changes in blood pressure, this study is really getting at the variability that is probably due to vascular injury as opposed to a response to stressors.  

However, variations in visit-to-visit blood-pressure readings can help identify high-risk patients. "A patient whose blood pressure is generally well controlled [<140/<90 mm Hg] but bouncing around a bit may be at a higher [CV] risk than someone whose blood pressure is consistent." Moreover, these patients do not have extreme fluctuations in systolic blood pressure. "We're not seeing people's blood pressure going from 120 to 160. We're talking about 120 to 135, back to 120, and then to 105."

Until recently, variations in office blood-pressure readings over time were dismissed as random fluctuations, however, some newer studies have linked inconsistent clinic blood-pressure readings with a higher risk for stroke and CHD.