Visit-to-Visit Blood Pressure Swings Tied to Higher Mortality in Diabetes Study
An observational study of 57,611 UK Biobank participants found that greater variation in systolic blood pressure between visits was associated with a higher risk of death during follow-up. People with type 2 diabetes and high systolic variability had 2.8 times the death risk of those with normal blood sugar and steadier readings, while prediabetes plus high variability was linked to a 62% higher risk. Some variability measures were also tied to stroke, suggesting that changes over time may offer information beyond average blood pressure readings.
The study included 57,611 UK Biobank volunteers, averaging 55.4 years old; 52% were women. At the start, 50,744 had normal glucose, 5,397 had prediabetes, and 1,470 had type 2 diabetes. During a median 5.1 years of follow-up, 1,460 deaths, 571 strokes, and 319 dementia cases occurred.
Researchers assessed changes from one research visit to another in systolic and diastolic pressure, mean arterial pressure, and pulse pressure. Larger swings in each measure corresponded with higher all-cause mortality, even after adjustment for average pressure, glucose category, and other variables. Each standard-deviation increase in systolic variability was linked to 11% higher death risk; diastolic variability showed an 8% increase.
This finding could prompt clinicians to consider blood pressure variability alongside average readings when monitoring people with diabetes or prediabetes. If confirmed, it may encourage more consistent measurement over multiple visits and help identify patients at higher risk. It could also add to patient discussions about cardiovascular risk, though observational results cannot show that reducing swings would lower mortality. The impact may be greatest for adults with abnormal glucose metabolism and their caregivers.