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CHICAGO — Middle-aged adults with significant long-term fluctuations in blood pressure may face a heightened risk of sudden cardiac death, according to a new study presented at the American Heart Association’s Scientific Sessions in Chicago. The findings suggest that blood pressure variability, often overlooked, could serve as a critical marker for cardiovascular health.
The study, published in the journal Circulation, analyzed data from 23,499 participants with an average age of 53 at the study’s onset. Blood pressure measurements were taken at least three times over 15 years, and participants were followed for up to 30 years. Researchers found that individuals with the greatest variability in systolic blood pressure—the top number in a blood pressure reading—had a 40% to 70% increased risk of sudden cardiac death compared to those with more stable readings.
“For every 1 mmHg increase in systolic blood pressure variability, the risk of sudden cardiac death rose by 3%,” explained lead researcher Ritam Patel, a second-year medical student at Northwestern University Feinberg School of Medicine. “This isn’t just about numbers; it’s about understanding the hidden risks that variability poses.”
Unveiling the Risks of Blood Pressure Variability
Blood pressure variability was found to be an independent risk factor for sudden cardiac death, regardless of whether initial blood pressure levels were high, low, or normal. Systolic readings varied by an average of 11–12 mmHg, while diastolic readings fluctuated by 6–7 mmHg.
Cardiologist Dr. Donald Lloyd-Jones, the study’s senior investigator, emphasized the potential of these findings in prevention strategies. “Blood pressure is dynamic, not static,” he said. “Tracking variability may provide valuable insights into who is at greatest risk so we can intervene earlier.”
The study builds on a growing body of research showing that uncontrolled high blood pressure increases risks for heart disease, stroke, and other chronic conditions. It adds to emerging evidence that fluctuations in blood pressure over time can have similarly serious consequences.
Potential Causes and Next Steps
The study did not delve into the mechanisms behind blood pressure variability and sudden cardiac death, but researchers speculate that the stress caused by constant fluctuations might strain the cardiovascular system.
“Our body isn’t designed to handle chronic yo-yoing,” Dr. Lloyd-Jones said. “These fluctuations may place a constant stress on the heart and arteries, accelerating damage.”
Dr. Wanpen Vongpatanasin, a hypertension expert at UT Southwestern Medical Center, who was not involved in the study, noted that further research is needed to understand what drives these fluctuations. “It could stem from poor medication adherence, lifestyle factors, or weight cycling. Identifying the root causes could pave the way for better prevention tools,” she said.
Implications for Patients and Physicians
The findings underscore the importance of monitoring not only blood pressure levels but also their stability over time. With advancements in electronic health records and home monitoring devices, tracking blood pressure variability may soon become a routine part of cardiovascular care.
“This opens a new window for prevention,” Patel said. “For millions of people already tracking their blood pressure, maintaining stability could be a lifesaving goal.”
As the research evolves, experts hope to use these insights to refine risk profiles and develop targeted strategies to mitigate the risks associated with blood pressure variability.
More Information
The study, Long-Term Blood Pressure Variability is Associated With Risk for Sudden Cardiac Death: Cardiovascular Lifetime Risk Pooling Project, is available in Circulation. For additional details, visit Circulation Journal.
