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Big blood pressure swings in young people could point to future cardiovascular problems

Researchers say doctors shouldn’t rely on average blood pressure readings

Photo (c) AlexRaths - Getty Images
It’s something that many consumers might have experienced when going to see their doctor. Your blood pressure could be reading low on one day, but it could spike up on a separate visit several months later. No big deal, right? 

Maybe not, according to researchers from Duke Health. The team found that big swings in blood pressure readings for younger consumers could point to future cardiovascular problems. 

“If a patient comes in with one reading in December and a significantly lower reading in January, the average might be within the range that would appear normal. But is that difference associated with health outcomes in later life?” asked Dr. Yuichiro Yano, the lead author of the study. “That’s the question we sought to answer in this study, and it turns out the answer is yes.”

Each reading matters, not just the average

The researchers came to their conclusions after analyzing data on nearly 3,400 people who took part in a study in the mid-1980s. The team looked at variations in blood pressure readings for each subject over a 10-year period and isolated those who experienced systolic blood pressure readings that were above 130 on individual visits, which would be an indicator for hypertension.

The researchers then tracked health outcomes for these individuals over the next 20 years and found that many of them wound up being affected by cardiovascular disease. In total, 182 subjects died over the 20-year period and there were 162 cardiovascular events. 

Diving deeper into the data, the researchers found that each 3.6 mm spike in systolic blood pressure equated to a 15 percent increase for cardiovascular events. This was true regardless of the average readings that subjects had when they were younger. 

The researchers say their findings indicate that doctors need to look more critically at individual blood pressure readings in order to deliver proper treatments, especially when their patients are younger.

“Current guidelines defining hypertension and assessing the need for anti-hypertensive therapies ignore variability in blood pressure readings. I think there has been a belief that variability is a chance phenomenon, but this research indicates maybe not. Variability matters,” Yano said. 

The full study has been published in JAMA Cardiology.

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