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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.

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We acknowledge The First Affiliated Hospital of Nanchang University, The Affiliated Hospital of Jiujiang University and The Second Affiliated Hospital of Nanchang University for support in preparation of this report. We thank LetPub ( for its linguistic assistance during the preparation of this manuscript.

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Correspondence to Zhi-ying Chen or Xiao-ping Yin.

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Conflict of Interest Statement

The authors declare that there is no conflict of interest with any financial organization or corporation or individual that can inappropriately influence this work.

The study was supported by grants from the National Natural Science Foundation of China (No. 81760221 and No. 81660209), National Science & Technology Foundational Resource Investigation Program of China (No. 2018FY100900), the Major Program of the Natural Science Foundation of Jiangxi Province (No. 2016ACB20015).

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Wang, H., Li, M., Xie, Sh. et al. Visit-to-visit Systolic Blood Pressure Variability and Stroke Risk: A Systematic Review and Meta-analysis. CURR MED SCI 39, 741–747 (2019).

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Key words

  • blood pressure
  • blood pressure variability
  • meta-analysis
  • stroke
  • systematic review
  • visit-to-visit systolic blood pressure