TL;DR
Turn quiet afternoons into listening time
- Thousands of audiobooks, podcasts and originals
- Listen on your phone, tablet or Echo — also offline
- Cancel anytime
A study presented at the EASD Annual Meeting found that greater variation in blood pressure between medical visits was linked to higher death risk and, for some measures, higher stroke risk among 57,611 UK Biobank participants. People with type 2 diabetes and high systolic variability were nearly three times more likely to die than those with normal blood sugar and low variability. The study was observational and did not prove causality.
Blood pressure that fluctuates widely from one medical visit to the next is associated with a higher risk of death, and in some measures with stroke, according to a study of more than 57,000 UK Biobank participants presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan. The researchers, from the Netherlands, reported that people with type 2 diabetes and high systolic blood pressure variability were almost three times more likely to die during follow-up than those with normal blood sugar and low variability — a finding that suggests fluctuation itself, not just average readings, may carry health information doctors currently do not use.
The study, led by Dr. Fariba Ahmadizar of the Department of General Practice at Amsterdam University Medical Center, included 57,611 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. The researchers calculated how much blood pressure varied between visits, accounting for the time between measurements, and followed participants for a median of 5.1 years. During that period, 319 participants developed dementia, 571 had a stroke, and 1,460 died.
Greater variability in each of the four blood pressure measures studied — systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure — was associated with a higher risk of death from any cause. These associations held after the researchers adjusted for average blood pressure, blood sugar status and other factors. Each one standard deviation increase in systolic blood pressure variability was associated with an 11% higher risk of death; the corresponding figure was 8% for diastolic variability.
Greater variability in diastolic blood pressure and mean arterial pressure was also associated with strokes, with the likelihood of a stroke 12% and 10% higher, respectively, per one-standard-deviation increase. The researchers note these percentages reflect differences between participants and cannot be directly translated into a change in blood pressure measured in mmHg. Combining blood sugar status and variability, participants with type 2 diabetes and high systolic variability were 2.8 times more likely to die than those with normal blood sugar and low variability; those with prediabetes and high variability had a 62% higher risk of death. The authors caution that these combined comparisons mean the increased risk cannot be attributed to blood pressure variability alone. The estimated 10-year risk of death was approximately 1.0% in the low-risk group versus approximately 2.9% in those with type 2 diabetes and high variability. No statistically significant associations were found for dementia.
Why Fluctuations, Not Just Averages, Matter
Current clinical practice assesses cardiovascular risk primarily through a patient’s average blood pressure, not how much readings vary over time. The study suggests that variability between visits carries information beyond the average reading, meaning some high-risk patients could currently be overlooked if their average blood pressure appears acceptable. The findings were strong enough to persist after adjustment for average blood pressure and blood sugar status, which the researchers say points to variability as a potentially independent risk marker. If confirmed by further research, variability could become an additional tool for identifying patients who would benefit from closer monitoring or earlier intervention.
How the UK Biobank Study Was Run
The research drew on the UK Biobank, a large long-term health study that collects repeated measurements from participants across visits. The Amsterdam-based team used blood pressure readings from an initial assessment plus at least one follow-up visit to calculate variability, adjusting for the intervals between measurements. Participants were grouped by blood sugar status — normal, prediabetes or type 2 diabetes — allowing the researchers to test how variability interacts with metabolic health. The results were presented at the EASD Annual Meeting in Milan, held September 28 to October 2, 2026, which is a standard venue for presenting diabetes-related research to the scientific community. Presentation at a conference means the findings have been shared with peers, though the source material does not state whether the full study has been published in a peer-reviewed journal.
“Our findings suggest that changes in blood pressure over time may provide information beyond the average blood pressure readings in routine care. However, more research is needed before blood pressure variability can be recommended for routine clinical use.”
— Dr. Fariba Ahmadizar, Department of General Practice, Amsterdam University Medical Center
What the Study Cannot Yet Show
Because the study was observational, it demonstrates an association, not causation — it remains possible that blood pressure fluctuations are a marker of underlying illness rather than a cause of the increased death and stroke risk. It is not yet known whether reducing blood pressure fluctuations is possible, or whether doing so would lower the risk of stroke or death. The combined diabetes-and-variability risk figures cannot be attributed to variability alone, as the study’s authors themselves note. The study also found no statistically significant association with dementia, and the standard-deviation-based percentages cannot be translated into specific mmHg changes for individual patients. Whether the findings apply beyond the study population, with an average age of 55.4 at baseline, is not addressed in the source material.
Before Variability Enters Routine Care
The researchers say blood pressure variability cannot yet be recommended for routine clinical use. Next steps they identify include determining whether fluctuations can be reduced — through medication changes, lifestyle measures or other interventions — and whether such reduction actually lowers the risk of stroke or death. Further research will also be needed to confirm the findings in other populations and to define practical thresholds at which variability would flag a patient as high risk. Readers concerned about their own blood pressure readings should discuss monitoring and management with a qualified healthcare professional.
Key Questions
Does fluctuating blood pressure cause death or strokes?
No causation has been established. The study was observational, and Dr. Ahmadizar stated it did not prove causality. It showed an association between greater between-visit variability and higher risk, which could reflect variability as a marker of other underlying conditions.
How much higher was the risk in the study?
Each one standard deviation increase in systolic blood pressure variability was associated with an 11% higher risk of death from any cause; for diastolic variability it was 8%. Stroke likelihood was 12% and 10% higher per standard deviation increase in diastolic and mean arterial pressure variability, respectively.
Should my doctor start measuring my blood pressure variability?
Not on the basis of this study alone. The lead researcher said more research is needed before variability can be recommended for routine clinical use, including whether reducing fluctuations lowers risk. Patients with concerns should raise them with a qualified healthcare professional.
Why did diabetes make the risk worse?
Participants with type 2 diabetes and high systolic variability were 2.8 times more likely to die than those with normal blood sugar and low variability. However, the authors caution this comparison combines blood sugar status and variability, so the increased risk cannot be attributed to variability alone.
Was dementia also linked to blood pressure variability?
No. The study found no statistically significant associations between blood pressure variability and dementia among the 319 participants who developed dementia during follow-up.
Source: rss
Fall Picks
fall essentials
As an affiliate, we earn on qualifying purchases.
