--- title: "Evidence: Blood pressure level and variability" description: "Variations in blood pressure over long, mid, and short terms are linked to increased risks of cardiovascular disease and mortality, independent of…" url: "https://magellanlongevity.com/study/s155.md" canonical: "https://magellanlongevity.com/study/s155.html" html: "https://magellanlongevity.com/study/s155.html" type: "study" study_key: "s155" journal: "BMJ" year: 2016 pmid: "27511067" doi: "10.1136/bmj.i4098" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Evidence: Blood pressure level and variability [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Evidence: Blood pressure level and variability **HTML version:** https://magellanlongevity.com/study/s155.html · **In the Magellan app:** https://magellanlongevity.com/#/study/s155 ## Citation | Field | Value | | --- | --- | | Journal | BMJ | | Year | 2016 | | PMID | [27511067](https://pubmed.ncbi.nlm.nih.gov/27511067/) | | DOI | [10.1136/bmj.i4098](https://doi.org/10.1136/bmj.i4098) | | Study key | s155 | ## Takeaway Variations in blood pressure over long, mid, and short terms are linked to increased risks of cardiovascular disease and mortality, independent of average blood pressure. ## The question What are the associations of long-term, mid-term, and short-term variability in blood pressure, independent of mean blood pressure, with cardiovascular disease events and mortality? ## Hypothesis The study aimed to systematically review existing evidence, implying an expectation that blood pressure variability would be associated with cardiovascular outcomes and mortality. ## Methods The researchers conducted a systematic review and meta-analysis of prospective cohort studies and clinical trials in adults, excluding those on hemodialysis patients. They searched Medline, Embase, Cinahl, and Web of Science up to February 15, 2016, for full-text English articles. Standardized hazard ratios were extracted and combined using random effects meta-analysis for main analyses, excluding studies with high confounding risk. Outcomes included all-cause mortality, cardiovascular disease mortality, and cardiovascular disease events, while variability measures included standard deviation, coefficient of variation, variation independent of mean, and average real variability. ## Results The review identified 41 papers (19 observational, 17 clinical trial cohorts) comprising 46 separate analyses. Long-term variability was studied in 24 papers, mid-term in four, and short-term in 15. After excluding 23 analyses due to high confounding risk, increased long-term variability in systolic blood pressure was associated with all-cause mortality (HR 1.15), cardiovascular disease mortality (HR 1.18), cardiovascular disease events (HR 1.18), coronary heart disease (HR 1.10), and stroke (HR 1.15). Increased mid-term and short-term variability in daytime systolic blood pressure were also associated with all-cause mortality (HR 1.15 and HR 1.10, respectively). ## Conclusion Long-term variability in blood pressure is associated with cardiovascular and mortality outcomes, independently of mean blood pressure, with associations similar in magnitude to those of cholesterol measures with cardiovascular disease. Limited data for mid-term and short-term variability showed similar associations. ## Limitations The study noted limited data for mid-term and short-term variability. A significant number of analyses (23) were excluded from the main analyses due to high risks of confounding, indicating a common pitfall in existing research. ## Verbatim from the abstract > long term variability in blood pressure is associated with cardiovascular and mortality outcomes ## Association of Increased Systolic Blood Pressure Variability with Outcomes (Hazard Ratios) | Measure | Hazard Ratio | | --- | --- | | Long-term variability: All-cause mortality | 1.15 | | Long-term variability: CVD mortality | 1.18 | | Long-term variability: CVD events | 1.18 | | Long-term variability: Coronary heart disease | 1.1 | | Long-term variability: Stroke | 1.15 | | Mid-term variability: All-cause mortality | 1.15 | | Short-term variability: All-cause mortality | 1.1 | *Hazard ratios for various outcomes associated with increased long-term, mid-term, and short-term systolic blood pressure variability.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | 24h Ambulatory BP Monitor | Strong evidence | [24h Ambulatory BP Monitor](https://magellanlongevity.com/p/155.md) | | Validated Home BP Monitor | Strong evidence | [Validated Home BP Monitor](https://magellanlongevity.com/p/163.md) | ## Reference 1. **Evidence: Blood pressure level and variability** BMJ 2016 · [PMID 27511067](https://pubmed.ncbi.nlm.nih.gov/27511067/) · [DOI 10.1136/bmj.i4098](https://doi.org/10.1136/bmj.i4098) > long term variability in blood pressure is associated with cardiovascular and mortality outcomes ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/s155.html#page","url":"https://magellanlongevity.com/study/s155.html","name":"Evidence: Blood pressure level and variability","description":"Variations in blood pressure over long, mid, and short terms are linked to increased risks of cardiovascular disease and mortality, independent of…","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/s155.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Evidence: Blood pressure level and variability","item":"https://magellanlongevity.com/study/s155.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/s155.html#study","name":"Evidence: Blood pressure level and variability","headline":"Evidence: Blood pressure level and variability","datePublished":"2016","isPartOf":{"@type":"Periodical","name":"BMJ"},"identifier":"PMID:27511067","url":"https://pubmed.ncbi.nlm.nih.gov/27511067/","sameAs":"https://doi.org/10.1136/bmj.i4098","abstract":"Variations in blood pressure over long, mid, and short terms are linked to increased risks of cardiovascular disease and mortality, independent of average blood pressure."}]} ``` ## Related on Magellan Longevity - [Validated Home BP Monitor](https://magellanlongevity.com/p/163.md) — product graded on this and related evidence - [24h Ambulatory BP Monitor](https://magellanlongevity.com/p/155.md) — product graded on this and related evidence - [Long-term systolic blood pressure variability is associated with mortality and…](https://magellanlongevity.com/study/d38103812.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).