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Variable Blood Pressure A New Stroke Risk Factor

Stroke is one of the three main critical illnesses according to the American Association for Critical Illness Insurance. 

Researchers at the University of Oxford looked at high blood pressure and blood pressure variability in four groups of 2,000 people, each of who had minor strokes called transient ischemic attacks (TIAs), or “mini-strokes.” These are warning signs of stroke risk. 

They found that people with the greatest variation in systolic blood pressure (the higher of the 120/80 readings) over seven visits to their doctor were six times more likely to have a major stroke. People with the highest blood pressure readings were 15 times more likely to have a stroke. 

Under-diagnosis and under-treatment of hypertension is a major, seemingly intractable problem in all health-care systems.  The new research shows that part of the problem is likely to have been under-recognition of the impact of variability in blood pressure on diagnosis in routine clinical practice in primary care. It shows that doctors have to make diagnoses on the basis of blood pressure measurements that vary substantially from visit to visit. 

The new research shows that increased variability in blood pressure, a high maximum blood pressure and episodic hypertension are associated with high risks of stroke and other vascular events, and emphasize that any comfort taken from the fact blood pressure is sometimes normal is false. 

The findings may also affect the choice of the first drugs prescribed for blood pressure control.

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