de Heus RAA, Tzourio C, Lee EJL, et al. - The direct comparison revealed that mean BP impact sizes were weaker than blood pressure variability (BPV) effect sizes, indicating that the relative contribution of BPV exceeded that of mean BP. The level of methodological and statistical heterogeneity was substantial. Secondary analyses were less consistent in determining whether BPV and mean BP were linked with dementia subtypes and cognitive domains differently.

• The primary analysis collected 54 effect sizes from 20 studies, with a total analytical sample of n = 7,899,697.

• Higher levels of systolic BPV, mean systolic pressure, diastolic BPV, and mean diastolic pressure were linked to dementia and cognitive impairment.