Recent research indicates that middle-aged individuals with significant variations in their blood pressure may be at a greater risk for sudden cardiac death compared to those with stable blood pressure levels. This study revealed that individuals with the highest blood pressure variability had a risk that was nearly 70% greater for experiencing sudden cardiac death compared to those with the least fluctuation. These preliminary results were showcased at the American Heart Association’s Scientific Sessions held in Chicago, although they are awaiting validation through peer-reviewed publication.
Lead researcher Ritam Patel, a second-year medical student from Northwestern University Feinberg School of Medicine, emphasized that blood pressure variability is more than just numbers; it signifies a concerning hidden risk that has been difficult to quantify. He stressed the importance for individuals monitoring their blood pressure to understand the significance of maintaining stability rather than focusing solely on the numbers themselves.
Numerous studies have established that poorly managed high blood pressure can significantly elevate the risk of heart disease, stroke, dementia, and other chronic conditions. The prevalence of high blood pressure rises with age, affecting nearly half of the adult population in the U.S. Researchers are increasingly studying the implications of fluctuating blood pressure readings over time, linking these variations with heightened risks for cardiovascular disease, cognitive decline, chronic kidney disease, and mental health disorders.
The current study analyzed the relationship between blood pressure fluctuations and sudden cardiac deaths among 23,499 participants, whose average age was 53 at the study’s outset. Participants had their blood pressure recorded at least three times over an average period of 15 years and were subsequently monitored for up to 30 years to track sudden cardiac deaths.
On average, systolic blood pressure, which measures arterial wall pressure when the heart beats, varied by approximately 11 to 12 millimeters of mercury (mmHg), while diastolic pressure, the measure between heartbeats, showed fluctuations of about 6 to 7 mmHg. After adjusting for various health factors, researchers noted that a 1 mmHg increase in systolic blood pressure variability corresponded to a 3% increase in risk for sudden cardiac death. Those with the most pronounced fluctuations in blood pressure faced a 40% to 70% heightened risk, regardless of their initial blood pressure status or the impact of aging.
Dr. Donald Lloyd-Jones, a cardiologist and senior investigator for the study, explained that monitoring blood pressure variability could potentially identify individuals at a heightened risk for sudden cardiac death, thus enabling preventive measures. He remarked that blood pressure naturally fluctuates over days, months, and years, and that an increasing availability of electronic health records may allow for improved tracking of variability data to better identify at-risk patients.
Patel noted that such insights could enhance understanding of a patient’s cardiovascular risk profile, presenting an opportunity to prevent severe outcomes. Lloyd-Jones added that while this study did not delve into the reasons behind the impact of blood pressure variability on heart health, it is possible that these fluctuations could induce additional stress on the body, as the body continuously responds to changing stimuli.
Dr. Wanpen Vongpatanasin from UT Southwestern Medical Center stressed the need for further investigation on what drives blood pressure fluctuations. She highlighted the difficulty in pinpointing a definitive cause, suggesting factors such as inconsistent medication adherence, lifestyle choices, or weight fluctuations as potential contributors. Recognizing the underlying factors contributing to these variations could provide tools to mitigate their adverse effects on heart health, she suggested.
Overall, this research underscores the necessity of addressing blood pressure variability in individuals to potentially reduce the risk of severe cardiovascular events, thereby promoting effective preventive strategies.