The investigators reviewed the electronic medical records of 42,482 patients whose blood pressure readings were taken at medical appointments occurring between 2013 and 2019. After calculating the variability of the patients' blood pressure readings, the investigators examined the associations between this variability and the patients' health outcomes. They found the greater the degree of fluctuation for a patient's blood pressure—regardless of the patient's average blood pressure level—the more likely it was that the patient would experience a cardiovascular event. This was true even after the investigators accounted for differences in age, sex and other medical problems the patients may have had.
Electronic health records could be programmed to automatically calculate blood pressure variability for individual patients, which could serve as an important tool to help doctors advise patients in real time, according to the authors.
"This study highlights a great example of how doctors could leverage electronic health record data to understand new information about a patient's cardiovascular risks while in the clinic," said senior author Susan Cheng, MD, MPH, the Erika J. Glazer Chair in Women's Cardiovascular Health and Population Science and director of the Institute for Research on Healthy Aging in the Department of Cardiology at the Smidt Heart Institute.
The authors next plan to study what noncardiovascular conditions may be linked with blood pressure variability and whether reducing blood pressure variability can decrease risk for adverse health events.
Other Cedars-Sinai investigators who worked on this study are Matthew Driver, MPH; David Ouyang, MD; Patrick Botting, MSHS; Mohamad Rashid, MBChB; Ciantel Blyler, PharmD; Natalie Bello, MD, MPH; Florian Rader, MD; and Christine Albert, MD, MPH.
Funding: This study was funded by the National Institutes of Health (award numbers R01-HL134168, R01-HL131532, R01-HL143227, R01-HL142983, U54-AG065141, R01-HL153382, K23-HL136853, K23-HL153888 and K99-HL157421), the China Scholarship Council grant (award number 201806260086), the Academy of Finland (award number 321351), the Emil Aaltonen Foundation and the Finnish Foundation for Cardiovascular Research.