Harvard Heart Letter

Heart Beat: Going steady

It's a fact of life, and of good health, that blood pressure bounces up and down throughout the day. Standing up, sitting down, exercising, eating, getting aggravated — all require blood pressure changes to maintain constant blood flow to the brain, the feet, and everything in between. But large swings from day to day could signal an increased risk of stroke or heart attack. In an analysis of the Anglo-Scandinavian Cardiac Outcomes blood pressure trial, participants with the biggest changes in blood pressure from one doctor visit to the next were four times more likely to have had a stroke or heart attack over the five-and-a-half-year trial than those with the smallest swings in visit-to-visit blood pressure (American College of Cardiology meeting, March 2010). While genetic differences probably account for some of the variation, use of one of the more powerful and longer-lasting blood pressure drugs, such as a calcium-channel blocker or ACE inhibitor, helped keep blood pressure steadier than did use of a beta blocker.

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