Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18–2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31–2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.

血压变异性 (BPV) 与心血管风险和血清尿酸水平相关。我们研究了别嘌呤醇是否可以降低 BPV，以及它是否与脑小血管疾病 (CSVD) 和认知的神经影像标志物相关。我们使用的数据来自一项随机、双盲、安慰剂对照试验，该试验对近期缺血性中风或短暂性脑缺血发作后进行两年的别嘌呤醇治疗。使用肱动脉血压 (BP) 记录评估每次就诊的 BPV。使用 4 周和 2 岁时进行的动态血压监测 (ABPM) 评估短期 BPV。在基线和 2 年时进行脑部 MRI 检查。对别嘌呤醇组和安慰剂组之间的 BPV 测量值以及 CSVD 和认知进行了比较。409 名参与者（205 名别嘌呤醇；204 名安慰剂）被纳入逐次访问 BPV 分析。对于任何访视 BPV 测量，安慰剂组和别嘌呤醇组之间均未发现显着差异。第 4 周的短期 BPV 分析纳入了 196 名参与者。别嘌呤醇降低了两项指标：收缩压的标准差 (SD)（降低 1.30 mmHg（95% 置信区间 (CI) 0.18–2.42，p = 0.023） ））；收缩压的平均真实变异性 (ARV)（1.31 mmHg (95% CI 0.31–2.32，p = 0.011)）。第 4 周时的其他测量值或 2 岁时的任何测量值均无差异，并且 BPV 与 CSVD 或认知无关。别嘌呤醇治疗不会影响近期缺血性中风或 TIA 患者的就诊 BPV。别嘌呤醇在第 4 周时降低了两项 BPV 测量值，但在 2 年时却没有降低。