HealthDay News — Variability in systolic blood pressure (SBP) in young adults is associated with an increased subsequent risk for cardiovascular disease (CVD) events and all-cause mortality, according to a study published online Jan. 22 in JAMA Cardiology.

Yuichiro Yano, MD, PhD, from Duke University in Durham, North Carolina, and colleagues conducted a prospective cohort study involving 3394 African-American and white young adults. Patterns of SBP were assessed, with measurements at baseline and during 10 years. Visit-to-visit variability in SBP was estimated as variability independent of the mean (VIM).

The researchers identified 162 CVD events and 181 deaths during a median follow-up of 20.0 years. When all BP pattern measurements were entered into the same model, including a single SBP measurement at the year 10 examination, for each 1-standard deviation increase in SBP measures, the hazard ratios for CVD events were 1.25 (95% confidence interval [CI], 0.90 to 1.74) for mean SBP, 1.23 (95% CI, 1.07 to 1.43) for VIM SBP, and 0.99 (95% CI, 0.81 to 1.26) for annual change of SBP. The only BP pattern associated with all-cause mortality was VIM for SBP (hazard ratio, 1.24; 95% CI, 1.09 to 1.41).

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

Several authors disclosed financial ties to the pharmaceutical industry.

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