HypertensionMeta-analysis
Visit-to-visit blood pressure variability and cardiovascular outcomes: a systematic review and dose-response meta-analysis
- Systematic review and dose-response meta-analysis
Authors' conclusion
The EHR data reliably estimate BPV, yielding effect sizes similar to those of non-EHR sources. A non-linear dose-response relationship suggests that a higher BPV increases CVD risk.
Study context
- Population
- Adults; studies of visit-to-visit BP variability and cardiovascular disease (CVD) outcomes (MI, stroke, HF, coefficient of variation (CV) mortality), published January 2012 to August 2024
- Participants
- 49 studies
- Comparison
- Electronic health record (EHR) vs non-EHR data for estimating visit-to-visit BP variability
- Outcome
- Association of visit-to-visit BP variability with any CVD outcome
Pooled result
As reported in the abstract
Any CVD outcome, per BPV
Hazard ratio (95% CI)
EHREHR studies
1.17(1.09–1.24)
non-EHRnon-EHR studies
1.14(1.10–1.17)
Per BPV, as printed
- VVV BPV predicted any CVD outcome; effect sizes comparable between EHR and non-EHR studies
- P = 0.468
Further pooled results
Dose-response: BPV threshold for 10% higher CVD risk
- SD threshold
- 6.72 mmHg
- CV threshold
- 9.05%
BPV estimation methodologies
- No consensus on BPV estimation methodologies; non-EHR studies followed stricter protocols
Original publication
Visit-to-visit blood pressure variability and cardiovascular outcomes: a systematic review and dose-response meta-analysis. Eur J Prev Cardiol. Published 28 August 2025. doi:10.1093/eurjpc/zwaf546
Summarised from the published abstract; every number is checked against it