Editing Blood pressure (section)

===Variable or fluctuating blood pressure===
{{Main|Labile hypertension}}
Some fluctuation or variation in blood pressure is normal. Variation in blood pressure that is significantly greater than the norm is known as [[labile hypertension]] and is associated with increased risk of cardiovascular disease<ref>{{cite journal | vauthors = Stevens SL, Wood S, Koshiaris C, Law K, Glasziou P, Stevens RJ, McManus RJ | title = Blood pressure variability and cardiovascular disease: systematic review and meta-analysis | journal = BMJ | volume = 354 | pages = i4098 | date = August 2016 | pmid = 27511067 | pmc = 4979357 | doi = 10.1136/bmj.i4098 }}</ref> brain small vessel disease,<ref>{{cite journal | vauthors = Tully PJ, Yano Y, Launer LJ, Kario K, Nagai M, Mooijaart SP, Claassen JA, Lattanzi S, Vincent AD, Tzourio C | display-authors = 6 | title = Association Between Blood Pressure Variability and Cerebral Small-Vessel Disease: A Systematic Review and Meta-Analysis | journal = Journal of the American Heart Association | volume = 9 | issue = 1 | pages = e013841 | date = January 2020 | pmid = 31870233 | pmc = 6988154 | doi = 10.1161/JAHA.119.013841 }}</ref> and dementia<ref name=":6"/> independent of the average blood pressure level.  Recent evidence from [[clinical trial]]s has also linked variation in blood pressure to mortality,<ref>{{cite journal | vauthors = Chiriacò M, Pateras K, Virdis A, Charakida M, Kyriakopoulou D, Nannipieri M, Emdin M, Tsioufis K, Taddei S, Masi S, Georgiopoulos G | display-authors = 6 | title = Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta-analysis | journal = Diabetes, Obesity & Metabolism | volume = 21 | issue = 12 | pages = 2587–2598 | date = December 2019 | pmid = 31282073 | doi = 10.1111/dom.13828 | s2cid = 195829708 | hdl = 11568/996646 }}</ref><ref>{{cite journal | vauthors = Nuyujukian DS, Newell MS, Zhou JJ, Koska J, Reaven PD | title = Baseline blood pressure modifies the role of blood pressure variability in mortality: Results from the ACCORD trial | journal = Diabetes, Obesity & Metabolism | volume = 24 | issue = 5 | pages = 951–955 | date = May 2022 | pmid = 35014154 | pmc = 8986598 | doi = 10.1111/dom.14649 | s2cid = 245896131 }}</ref> stroke,<ref>{{cite journal | vauthors = Muntner P, Whittle J, Lynch AI, Colantonio LD, Simpson LM, Einhorn PT, Levitan EB, Whelton PK, Cushman WC, Louis GT, Davis BR, Oparil S | display-authors = 6 | title = Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality: A Cohort Study | journal = Annals of Internal Medicine | volume = 163 | issue = 5 | pages = 329–338 | date = September 2015 | pmid = 26215765 | pmc = 5021508 | doi = 10.7326/M14-2803 }}</ref> heart failure,<ref>{{cite journal | vauthors = Nuyujukian DS, Koska J, Bahn G, Reaven PD, Zhou JJ | title = Blood Pressure Variability and Risk of Heart Failure in ACCORD and the VADT | journal = Diabetes Care | volume = 43 | issue = 7 | pages = 1471–1478 | date = July 2020 | pmid = 32327422 | pmc = 7305004 | doi = 10.2337/dc19-2540 | hdl-access = free | hdl = 10150/641980 }}</ref> and cardiac changes that may give rise to heart failure.<ref>{{cite journal | vauthors = Nwabuo CC, Yano Y, Moreira HT, Appiah D, Vasconcellos HD, Aghaji QN, Viera A, Rana JS, Shah RV, Murthy VL, Allen NB, Schreiner PJ, Lloyd-Jones DM, Lima JA | display-authors = 6 | title = Association Between Visit-to-Visit Blood Pressure Variability in Early Adulthood and Myocardial Structure and Function in Later Life | journal = JAMA Cardiology | volume = 5 | issue = 7 | pages = 795–801 | date = July 2020 | pmid = 32293640 | pmc = 7160747 | doi = 10.1001/jamacardio.2020.0799 }}</ref> These data have prompted discussion of whether excessive variation in blood pressure should be treated, even among normotensive older adults.<ref>{{cite journal | vauthors = Parati G, Ochoa JE, Lombardi C, Bilo G | title = Assessment and management of blood-pressure variability | journal = Nature Reviews. Cardiology | volume = 10 | issue = 3 | pages = 143–155 | date = March 2013 | pmid = 23399972 | doi = 10.1038/nrcardio.2013.1 | s2cid = 22425558 }}</ref>

Older individuals and those who had received blood pressure medications are more likely to exhibit larger fluctuations in pressure,<ref name="ncbi.nlm.nih.gov">{{cite journal | vauthors = Brickman AM, Reitz C, Luchsinger JA, Manly JJ, Schupf N, Muraskin J, DeCarli C, Brown TR, Mayeux R | display-authors = 6 | title = Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort | journal = Archives of Neurology | volume = 67 | issue = 5 | pages = 564–569 | date = May 2010 | pmid = 20457955 | pmc = 2917204 | doi = 10.1001/archneurol.2010.70 }}</ref> and there is some evidence that different antihypertensive agents have different effects on blood pressure variability;<ref name=":6">{{cite journal | vauthors = Messerli FH, Hofstetter L, Rimoldi SF, Rexhaj E, Bangalore S | title = Risk Factor Variability and Cardiovascular Outcome: JACC Review Topic of the Week | journal = Journal of the American College of Cardiology | volume = 73 | issue = 20 | pages = 2596–2603 | date = May 2019 | pmid = 31118154 | doi = 10.1016/j.jacc.2019.02.063 | doi-access = free }}</ref> whether these differences translate to benefits in outcome is uncertain.<ref name=":6" />