scholarly journals Mortality Implications of Angina and Blood Pressure in Hypertensive Patients With Coronary Artery Disease: New Data From Extended Follow-up of the International Verapamil/Trandolapril Study (INVEST)

2013 ◽  
Vol 36 (8) ◽  
pp. 442-447 ◽  
Author(s):  
David E. Winchester ◽  
Rhonda M. Cooper-DeHoff ◽  
Yan Gong ◽  
Eileen M. Handberg ◽  
Carl J. Pepine ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hypertensive Patients ◽  
Artery Disease

P5468Systolic versus diastolic blood pressure as predictors of cardiovascular events among treated hypertensive patients: a 6-year prospective study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kasiakogias ◽  
C Tsioufis ◽  
D Konstantinidis ◽  
P Iliakis ◽  
I Leontsinis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Events ◽  
Cardiovascular Morbidity ◽  
Hypertensive Patients ◽  
Artery Disease ◽  
Worse Prognosis

Abstract Background/Introduction There has been a long debate regarding the association of systolic versus diastolic blood pressure with cardiovascular outcome and data regarding hypertensive patients under treatment have been conflicting. Purpose To investigate the association of different patterns of uncontrolled blood pressure (BP) among treated hypertensive patients. Methods We prospectively studied 1507 treated hypertensive patients (age 59±11 years) that are followed in the setting of a single-center, clinic-based registry. During follow-up, patients underwent regular visits for hypertension and risk factor management. Based on the cut-off limits for uncontrolled hypertension of office systolic BP≥140mmHg and diastolic BP≥90mmHg, study participants were divided into four groups: those with controlled hypertension (796 patients, 53% of the population), uncontrolled systolic BP (257 patients, 17%), uncontrolled diastolic BP (135 patients, 9%) and uncontrolled systolic and diastolic BP (319 patients, 21%). The outcome studied was the composite of cardiovascular morbidity set as coronary artery disease and stroke, and the controlled hypertension group served as reference. Results The median follow-up period was 6.4±3.0 years and the composite endpoint (13 strokes and 41 cases of coronary artery disease) occurred in 54 patients (3.6%). Unadjusted Cox regression analysis showed that, compared to the reference group of controlled hypertensives, the risk for cardiovascular morbidity was similar in patients with uncontrolled diastolic BP (HR: 0.88, 95% CI: 0.26–2.97) but significantly higher in patients with uncontrolled systolic BP (HR: 2.17, 95% CI: 1.08–4.36), while patients with both uncontrolled systolic and diastolic BP showed the worse prognosis (HR: 2.35, 95% CI: 1.24–4.43). This pattern of risk was overall sustained after adjusting for different sets of confounders. Conclusions Among treated hypertensive patients, uncontrolled systolic BP is associated with a greater risk for cardiovascular events compared to uncontrolled diastolic BP while uncontrolled systolodiastolic hypertension presents with the worse prognosis.

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