Fluctuating blood pressure may increase risk of stroke Print

New research suggests that people with occasionally high blood pressure are more at risk of stroke than those with consistently high readings.

People with fluctuating blood pressure could be more at risk of stroke

New research suggests that people with occasionally high blood pressure are more at risk of stroke than those with consistently high readings.

To reduce the chance of suffering a stroke current guidelines focus on the need to lower blood pressure levels.

This latest research says doctors should aim to achieve steady blood pressure levels and no longer ignore an occasional high reading.

The Stroke Association called for national guidelines to be overhauled.

UK and Swedish researchers looked at the variability in blood pressure readings by doctors.

They established that people with fluctuating readings at different visits had the greatest risk of having a stroke in the future regardless of what their average blood pressure reading was.

The research also reviewed previous trials and found that the differences in effectiveness of a number of blood pressure drugs could be explained by how well they kept blood pressure steady.

In a separate study in The Lancet, some drugs were found to increase variation in blood pressure, this was particularly true of beta blockers.

Professor Peter Rothwell of the Department of Clinical Neurology at the University of Oxford, who led the research, said the findings have major implications for guidnace given to GPs to help them spot and treat people at high risk of a stroke.

"At the moment, the guidelines for GPs say not to believe a one-off unusual reading, to bring the patient back and measure again, and as long as it's not consistently high, there is no need to treat.

"What we're saying is don't discount that one-off high blood pressure reading."

He added that GPs would also need to try and prescribe drug combinations that lower blood pressure but also stabilise it.

The research has not established why fluctuations would increase a person's risk of stroke but it is thought the body's system is put under extra stress.

"If you get rapid fluctuations that can cause turbulent flow of blood which can cause damage and stiffening in the arteries," said Professor Rothwell.

He said anyone with high blood pressure who tests themselves at home with a blood pressure monitor should mention to their GP if they get variations in their results.

The National Institute for Health and Clinical Excellence's guidelines on high blood pressure is in the process of being rewritten and these latest studies will be taken into account.

Joe Korner, director of communications at The Stroke Association said people who have occasional high blood pressure readings (known as episodic hypertension) are often not treated.

"With this new research it is now important that the clinical guidelines about treating high blood pressure are reviewed."

"In the meantime we urge GPs to read this research to help them prescribe the best treatment for people at risk of stroke."

Experts stressed that those who are getting fluctuations and/or already prescribed medication for high blood pressure should not worry or stop taking their pills; it is a long term view.

Professor Peter Weissberg, medical director at the British Heart Foundation said: "Current practice is not wrong, but this might add a new measure to help doctors make decisions on who to treat for hypertension and which drug to use."