HypertensionMeta-analysis
Blood pressure variability and cardiovascular events in high-risk individuals: individual patient data analysis of SPRINT and ACCORD trials
- Individual patient data pooled analysis of the SPRINT and ACCORD randomised trials
- patient-level pooled analysis
Authors' conclusion
Visit-to-visit BPV was independently associated with the risk of MCEs, particularly myocardial infarction and cardiovascular death, with a J-shaped relationship indicating that both low and high BPV may be harmful.
Study context
- Population
- High-risk individuals in the SPRINT and ACCORD trials with ≥3 visits
- Participants
- 18,415 individuals · 2 RCTs
- Comparison
- Highest vs lowest tertile of visit-to-visit SBP variability
- Outcome
- Major cardiovascular events:
- MI
- Stroke
- CV death
- Follow-up
- 3.6-year follow-up
Pooled result
MCEs
Hazard ratio
1.15
95% CI 1.00–1.32
Highest tertile vs Lowest tertile
HR 1.15 (95% CI 1.00–1.32)
As reported in the abstract
- Major cardiovascular events (MCEs) overall
- 1244 (6.8%)
Further pooled results
MI and CV death
- Similar associations with higher SBP-VIM
Shape of SBP-VIM–outcome relationship
- J-shaped relationship
- all P < .05
Prognostic value vs mean SBP
- SBP-VIM comparable to mean SBP; consistent across blood pressure variability (BPV) metrics, stronger with extended follow-up
Original publication
Blood pressure variability and cardiovascular events in high-risk individuals: individual patient data analysis of SPRINT and ACCORD trials. Eur Heart J. Published 14 May 2026. doi:10.1093/eurheartj/ehag330
Summarised from the published abstract; every number is checked against it