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A study of 57,611 UK Biobank participants found that greater variation in blood pressure between research visits was associated with higher risk of death, even after accounting for average blood pressure. Some measures of variation were also associated with stroke, but the observational findings do not show that blood pressure fluctuations cause these outcomes.
Greater variation in blood pressure between research visits was associated with a higher risk of death in a study of 57,611 UK Biobank participants, researchers reported at the European Association for the Study of Diabetes annual meeting in Milan. Variation in some blood pressure measures was also associated with stroke, though the observational study cannot establish cause and effect.
The study, led by Dr. Fariba Ahmadizar of Amsterdam University Medical Center in the Netherlands, included participants who had blood pressure recorded at their 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 assessed variation across visits in four measures: systolic and diastolic blood pressure, mean arterial pressure and pulse pressure. They accounted for the time between measurements. Over a median follow-up of 5.1 years from the first visit at which variability could be calculated, 1,460 participants died, 571 had a stroke and 319 developed dementia.
Higher variation in all four measures was associated with a greater risk of death from any cause. The associations remained after researchers adjusted for average blood pressure, blood sugar status and other factors. For each one-standard-deviation increase in variability, systolic pressure was associated with an 11% higher risk of death and diastolic pressure with an 8% higher risk. Greater variation in diastolic pressure and mean arterial pressure was associated with 12% and 10% higher stroke risk, respectively.
Why Visit-to-Visit Changes Matter
Routine health assessments commonly consider a person’s average blood pressure, while variation between visits is not routinely included, according to the report. The findings suggest that fluctuations could provide additional information about risk and might help identify people who would otherwise be overlooked. That possibility could matter for people with diabetes, who may face added risk when blood pressure variation is also high.
The study reported that participants with type 2 diabetes and high systolic pressure variability were 2.8 times as likely to die during follow-up as those with normal blood sugar and low variability. The estimated 10-year death risk was about 2.9% in the former group and 1.0% in the latter. These are comparisons between groups that differ in both blood sugar status and blood pressure variability; they do not isolate the contribution of variability alone.
The reported percentage increases for each standard-deviation change describe differences in variability across participants. They are not direct changes in blood pressure in millimeters of mercury and should not be read as a forecast for an individual. The results may inform future research, but they do not establish a new clinical threshold or show that changing fluctuations would prevent illness or death.
How Researchers Measured Variation
Blood pressure can differ from one visit to another. In this study, researchers calculated how much each participant’s readings varied over time, while taking the interval between measurements into account. They then examined whether those measures were associated with deaths, strokes and dementia during follow-up.
The researchers also compared outcomes across groups defined by blood sugar status and systolic blood pressure variability. Participants with prediabetes and high variability had a 62% higher risk of death than those with normal blood sugar and low variability. Because the groups differed on both measures, the comparison cannot show that blood pressure variation alone accounts for the difference.
No statistically significant association was found between blood pressure variability and dementia in the analysis. The study was presented at the EASD Annual Meeting, held in Milan from September 28 to October 2, 2026. The supplied report describes the findings from a UK Biobank participant group and does not report an intervention designed to alter blood pressure variation.
“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
Questions About Cause and Treatment
The findings show associations, not causation. The researchers did not test whether reducing blood pressure variation lowers the risk of stroke or death, and the report does not identify a fluctuation level at which clinical action should begin. It is also unclear whether the associations would be similar in other populations or under different patterns of blood pressure monitoring.
The combined diabetes and high-variability comparison cannot determine how much of the higher risk is linked to either factor separately. Although the study reported that dementia was not significantly associated with the measures examined, that result does not establish that variability has no relationship to dementia in other groups or studies. The available report does not provide further details on those questions.
Evidence Needed Before Clinical Use
Further research will need to test whether blood pressure variation can be reduced and whether reducing it changes the risk of stroke or death. Studies will also need to establish how variability should be measured and whether it adds useful information to existing assessments across different patient groups.
Until that evidence is available, the researchers say variability should not be treated as an established basis for routine clinical decisions. The meeting presentation reports a possible risk marker; it does not show that acting on the marker improves health outcomes.
Key Questions
What did the study find?
Greater variation in blood pressure between research visits was associated with higher risk of death. Variation 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 measured at an initial assessment and at least one later visit.
Did the study show that blood pressure variation causes death or stroke?
No. It was an observational study, so it found associations but did not prove that variation caused the outcomes.
Was blood pressure variation linked to dementia?
The researchers found no statistically significant association between the blood pressure measures and dementia in this analysis.
Can these findings guide treatment now?
The report says more research is needed before variability can be recommended for routine clinical use. The study did not test whether reducing fluctuations lowers health risks.
Source: rss
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