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New blood pressure measures could prevent strokes and heart attacks

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A study that challenges current blood pressure readings may have major implications for preventing strokes and heart attacks.

It suggests variations in blood pressure rather than high average readings are a better indicator of the risk of heart failure, angina and heart attacks.

Leader of the study Professor Peter Rothwell, from the University of Oxford, said: “Occasional high values, and what might be called episodic hypertension, carry a high risk of stroke. Previously, such fluctuations were considered to be benign and uninformative.”

Experts say clinical guidelines for treating patients should now be reviewed, as currently no special importance is attached to fluctuations in blood pressure.

Researchers looked at how blood pressure variability affected stroke risk in four large groups of participants in previous international trials, each including more than 2,000 patients. The findings are reported in the Lancet medical journal.

All the patients had previously experienced a so-called “mini-stroke”, or transient ischaemic attack (TIA).

Patients with the most variation in systolic blood pressure - the pressure measured with each “surge” of the beating heart - were six times more likely to have a stroke than those with the least.

Individuals with the highest blood pressure recorded over a series of seven clinic visits had a 15-fold increased stroke risk.

Visit-to-visit blood pressure fluctuations were also warning signs of heart failure, angina and heart attacks independent of average blood pressure.

Professor Peter Rothwell, from the University of Oxford, who led the study, said: “Occasional high values, and what might be called episodic hypertension, carry a high risk of stroke. Previously, such fluctuations were considered to be benign and uninformative.”

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