Visit-to-visit Systolic Blood Pressure Variability and Stroke Risk: A Systematic Review and Meta-analysis

Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship between visit-to-visit SBP variability(SBPV)and stroke risk.PubMed,EMBASE,and the Cochrane library databases were searched for cohort studies with data on visit-to-visit SBPV and stroke risk.Studies that reported adjusted relative risks(RRs)with 95%Cis of stroke associated with SBPV were included.Fourteen cohort studies met the inclusion criteria and were included in our meta-analysis.After adjustment for age,sex,and existing vascular risk factors,the analysis showed that the risk of stroke in patients with SBPV was significantly increased compared with patients with a small baseline SBPV[SD(RR=1.20,95%CI=(1.07-1.35),P=0.0005),CV(RR=1.12,95%CI=(1.00-1.26),P=0.008)].In addition,follow-up variations of more than 5 years were associated with a higher risk of stroke than those of less than 5 years[RR=1.08,95%CI=(1.04-1.11)].Visit-to-visit SBPV was associated with an increased risk of stroke,especially in terms of the time of variation.Taken together,SBPV data may be useful as a preventative diagnostic method in the management of stroke.