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This study expanded upon existing evidence by examining the association between changes in SBPV over time and clinical outcomes in primary care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Visit-to-visit SBPV was determined as standard deviation of \u22653 systolic blood pressure values measured at 5\u201310 (Period 1) and 0\u20135 (Period 2) years before enrolment in the UK Biobank. Cox proportional hazards models were used to evaluate associations of absolute changes in SBPV and SBPV change patterns between these two periods with risk of cardiovascular disease (CVD), coronary heart disease (CHD), stroke, atrial fibrillation and flutter (AF), heart failure (HF), chronic kidney disease (CKD), dementia, and overall mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 36 251 participants were included with a median follow-up time of 13.9 years. In the fully adjusted models, an increased SBPV from Period 1 to Period 2 was significantly associated with an increased risk of CVD, CHD, stroke, CKD, and overall mortality (all P for trend &amp;lt; .005), reflecting a 23%\u201333% increased risk comparing participants with an increase in SBPV above Tertile 3 with those below Tertile 1. An increase in SBPV from Period 1 to Period 2 appeared to be associated with an increased risk of AF, HF, and dementia; however, the associations did not reach statistical significance at P &amp;lt; .005. The restricted cubic spline analysis did not reveal non-linear associations, as all P-values for non-linearity were &amp;gt;.05. Regarding SBPV change patterns, compared with the participants with consistently low SBPV, participants with a consistently high SBPV during the two periods had an increased risk of CVD, CHD, stroke, AF, HF, CKD, and overall mortality, with a risk evaluation of 28%\u201346%. The observed associations remained largely unchanged across subgroup and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An increase in SBPV over time was associated with an elevated risk of CVD, CKD, and overall mortality. These findings provide compelling evidence to inform the importance for the management of SBPV in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf256","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T21:17:17Z","timestamp":1743369437000},"page":"2673-2687","source":"Crossref","is-referenced-by-count":40,"title":["Systolic blood pressure variability: risk of cardiovascular events, chronic kidney disease, dementia, and death"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8766-0594","authenticated-orcid":false,"given":"Xunjie","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Center of Coronary Circulation, Xiangya Hospital of Central South University , Xiangya Road 87#, Changsha 410008 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Changsha 410008 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7627-0404","authenticated-orcid":false,"given":"Lingfang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Xiangya Hospital of Central South University , Changsha ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3310-6456","authenticated-orcid":false,"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8678-2167","authenticated-orcid":false,"given":"Guogang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Xiangya Hospital of Central South University , Xiangya Road 87#, Changsha 410008 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7808-9477","authenticated-orcid":false,"given":"Jiaqi","family":"Huang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University , Renmin Middle Road 139#, Changsha 410011 ,","place":["China"]},{"name":"Xiangya School of Public Health, Central South University , Changsha ,","place":["China"]},{"name":"CSU-Sinocare Research Center for Nutrition and Metabolic Health , Changsha ,","place":["China"]},{"name":"Furong Laboratory , Changsha 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