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A study presented at the European Association for the Study of Diabetes meeting linked greater variation in blood pressure between research visits with higher risk of death among 57,611 UK Biobank participants. Some measures of variability were also associated with stroke, but the observational findings do not show that fluctuations cause these outcomes or that tracking them would prevent them.
A study of 57,611 UK Biobank participants found that greater variation in blood pressure between research visits was associated with a higher risk of death, while variability in some measures was also linked to stroke. Researchers from the Netherlands presented the findings at the European Association for the Study of Diabetes meeting in Milan, held September 28 to October 2, 2026; the observational study does not establish that blood pressure fluctuations cause these outcomes.
Led by Dr. Fariba Ahmadizar of Amsterdam University Medical Center, the study included participants who had blood pressure measured at an initial assessment and at least one later visit. Their average age was 55.4 years, and 52% were women. At the start, 50,744 had normal blood sugar, 5,397 had prediabetes and 1,470 had type 2 diabetes. Researchers accounted for the time between visits when calculating how much readings varied.
Participants were followed for a median of 5.1 years from the first visit at which variability could be calculated. During follow-up, 1,460 died, 571 had a stroke and 319 developed dementia. Higher variability across all four measures studied — systolic pressure, diastolic pressure, mean arterial pressure and pulse pressure — was associated with death from any cause. The associations remained after the researchers adjusted for average blood pressure, blood sugar status and other factors.
For each one-standard-deviation increase in variability, systolic pressure variability was associated with an 11% higher risk of death, and diastolic variability with an 8% higher risk. Greater variability in diastolic pressure and mean arterial pressure was associated with stroke risks 12% and 10% higher, respectively, per standard-deviation increase. These relative percentages do not translate into a specific change in blood pressure in mmHg.
Why Visit-to-Visit Readings Matter
Routine assessment commonly focuses on average blood pressure. The authors say their results suggest changes between visits may carry additional information about health risks, potentially pointing to people whose average readings alone do not flag elevated risk. This could matter for future risk assessment if further research confirms that variability adds useful information beyond established measures.
The study also found a pronounced difference when blood sugar status and systolic variability were considered together. Participants with type 2 diabetes and high systolic variability were 2.8 times as likely to die during follow-up as those with normal blood sugar and low variability. That comparison combines two characteristics, so it cannot show how much of the difference is attributable to variability itself. The authors estimated 10-year death risk at about 1.0% for the normal-blood-sugar, low-variability group and 2.9% for the type 2 diabetes, high-variability group.
These findings do not show that monitoring or lowering variability would reduce deaths or strokes. They identify an association for researchers to examine, rather than a new clinical recommendation.
How Researchers Measured Variation
The analysis used repeated blood pressure readings from research visits in the UK Biobank. Rather than measuring only a participant’s average, the researchers assessed how much the readings changed from one visit to another, taking the time interval between measurements into account. They examined four blood pressure measures and compared outcomes across differing levels of variability.
Blood sugar groups were also considered. Participants with prediabetes had blood sugar higher than normal but below the level used to classify diabetes, according to the source report. For the combined analysis, the reference group had normal blood sugar and low systolic variability. People with prediabetes and high variability had a 62% higher risk of death than that reference group; this, too, combines differences in blood sugar and variability.
The study assessed deaths, strokes and new dementia diagnoses during follow-up. The researchers reported no statistically significant association with dementia. That result means the analysis did not identify a statistically significant relationship; it does not establish that no relationship exists.
“Our findings suggest that changes in blood pressure over time may provide information beyond the average blood pressure readings in routine care.”
— Dr. Fariba Ahmadizar, Amsterdam University Medical Center
Limits of the Current Evidence
The study was observational, so it cannot establish that blood pressure variability caused deaths or strokes. Adjustment for average pressure, blood sugar and other factors does not rule out all possible explanations. The reported three-year? No: the follow-up period was a median of 5.1 years, and the 10-year figures were estimates, not observed outcomes over a full decade.
It is also unclear whether blood pressure fluctuations can be reduced in a way that changes health outcomes. The source report does not provide enough information to assess how representative the participants were of the wider population or whether the findings apply equally across patient groups. No statistically significant dementia association was found in this analysis.
Questions for Clinical Research
Ahmadizar said further research is needed before blood pressure variability can be recommended for routine clinical use. A key question is whether the fluctuations can be reduced and, if so, whether doing so lowers the risk of stroke or death. Future studies would also need to determine whether variability improves risk identification beyond average readings and other existing clinical information.
Until those questions are answered, the findings remain a research result presented at a scientific meeting. The report does not establish a change to routine blood pressure assessment or treatment based on variability alone.
Key Questions
What did the study find?
Greater variation in blood pressure between research visits was associated with a higher risk of death. Variability in diastolic pressure and mean arterial pressure was also associated with higher stroke risk.
How many people took part?
The analysis included 57,611 UK Biobank participants with blood pressure measurements at an initial assessment and at least one later visit.
Does the study prove that blood pressure fluctuations cause strokes or death?
No. The study was observational and found associations; it cannot establish cause and effect.
Does this mean blood pressure variability should be monitored routinely?
No such recommendation was made. The study authors said more research is needed before variability can be recommended for routine clinical use.
Was variability associated with dementia?
The researchers reported no statistically significant associations with dementia in this analysis.
Source: rss
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