scholarly journals Systolic blood pressure and mortality in patients with atrial fibrillation and heart failure: insights from the AFFIRM and AF-CHF studies

2014 ◽  
Vol 16 (11) ◽  
pp. 1168-1174 ◽  
Author(s):  
Maxime Tremblay-Gravel ◽  
Paul Khairy ◽  
Denis Roy ◽  
Hugues Leduc ◽  
D. George Wyse ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure

scholarly journals Benefit and harm of intravenous vasodilators across the clinical profile spectrum in acute cardiogenic pulmonary oedema patients

2020 ◽  
Vol 9 (5) ◽  
pp. 448-458 ◽  
Author(s):  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Toshiomi Katsuki ◽  
Kazumasa Harada ◽  
Tetsuro Miyazaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Acute Heart Failure ◽  
Large Scale ◽  
Inhospital Mortality ◽  
Registration System ◽  
Heart Failure Patients ◽  
Blood Pressures

Background: The absence of high quality, large-scale data that indicates definitive mortality benefits does not allow for firm conclusions on the role of intravenous vasodilators in acute heart failure. We aimed to investigate the associations between intravenous vasodilators and clinical outcomes in acute heart failure patients, with a specific focus on patient profiles and type of vasodilators. Methods: Data of 26,212 consecutive patients urgently hospitalised for a primary diagnosis of acute heart failure between 2009 and 2015 were extracted from a government-funded multicentre data registration system. Propensity scores were calculated with multiple imputations and 1:1 matching performed between patients with and without vasodilator use. The primary endpoint was inhospital mortality. Results: On direct comparison of the vasodilator and non-vasodilator groups after propensity score matching, there were no significant differences in the inhospital mortality rates (7.5% vs. 8.8%, respectively; P=0.098) or length of intensive/cardiovascular care unit stay and hospital stay between the two groups. However, there was a substantial difference in baseline systolic blood pressure by vasodilator type; favourable impacts of vasodilator use on inhospital mortality were observed among patients who had higher systolic blood pressures and those who had no atrial fibrillation on admission. Furthermore, when compared to nitrates, the use of carperitide (natriuretic peptide agent) was significantly associated with worse outcomes, especially in patients with intermediate systolic blood pressures. Conclusions: In acute heart failure patients, vasodilator use was not universally associated with improved inhospital outcomes; rather, its effect depended on individual clinical presentation: patients with higher systolic blood pressure and no atrial fibrillation seemed to benefit maximally from vasodilators. Trial registration: UMIN-CTR identifier, UMIN000013128

RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASES AND ANATOMOSIS OF ARTERIOVENOUS FISTULAR IN PATIENTS WITH REGULARLY HEMODIALYSIS

2017 ◽  
pp. 88-92
Author(s):  
Van Hien Pham ◽  
Huu Vu Quang Nguyen ◽  
Tam Vo
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Cardiovascular Diseases ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Negative Correlation ◽  
Mean Value ◽  
The Mean

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.

scholarly journals Systolic blood pressure at admission and long‐term clinical outcomes in patients hospitalized for heart failure

2021 ◽  
Author(s):  
Xinghe Huang ◽  
Jiamin Liu ◽  
Shuang Hu ◽  
Lihua Zhang ◽  
Fengyu Miao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Clinical Outcomes

scholarly journals Hypertensive response in exercise - a tool to predict stroke risk?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TE Graca Rodrigues ◽  
N Cunha ◽  
P Silverio-Antonio ◽  
P Couto Pereira ◽  
B Valente Silva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Exercise Test ◽  
Cardiovascular Events ◽  
Protective Factor ◽  
Independent Predictor ◽  
Stress Test ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is some evidence suggesting that exaggerated hypertensive response to exercise (HRE) may be associated with higher risk of future cardiovascular events, however the relationship between systolic blood pressure (SPB) during exercise test and stroke is not fully understood. Purpose To evaluate the ability to predict the risk of stroke in patients with HRE in exercise test. Methods Single-center retrospective study of consecutive patients submitted to exercise test from 2012 to 2015 with HRE to stress test. HRE was defined as a peak systolic blood pressure (PSBP) &gt; 210 mmHg in men and &gt; 190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure &gt; 90 mmHg or a rise of 10 mmHg. Patient’s demographics, baseline clinical characteristics, vital signs during the stress test and the occurrence of stroke during follow-up were analysed Results We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%), dyslipidaemia (61%), previously known coronary disease (32%), diabetes (28%) and smoking (38%). Atrial fibrillation was present in 5.9% of patients. During a mean follow-up of 60 ± 2 months, the incidence of stroke was 2.1% (n = 8), all with ischemic origin. Considering the parameters analysed on exercise test, only PSBP demonstrated to be an independent predictor of stroke (HR 1.042, CI95% 1.002-1.084, p = 0.039,) with moderate ability to predict stroke (AUC 0.735, p = 0.0016) with a most discriminatory value of 203 mmHg (sensibility 56%, specify 67%). Regarding baseline characteristics, after age, sex and comorbidities adjustment, previously controlled hypertension was found to be an independent protective factor of stroke (OR 4.247, CI 95% 0.05-0.9, p = 0.036) and atrial fibrillation was an independent predictor of stroke occurrence (HR 8.1, CI95% 1.4-46.9, p = 0.018). Atrial fibrillation was also associated with hospitalization of cardiovascular cause and major cardiovascular events occurrence (mortality, coronary syndrome and stroke). Baseline SBP was associated with atrial fibrillation development (p = 0.008). Conclusion According to our results, PSBP during exercise test is an independent predictor of stroke occurrence and should be considered as a potencial additional tool to predict stroke occurrence, particularly in high risk patients. The identification of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs.

scholarly journals Systolic blood pressure reduction during the first 24 h in acute heart failure admission: friend or foe?

2017 ◽  
Vol 20 (2) ◽  
pp. 317-322 ◽  
Author(s):  
Gad Cotter ◽  
Marco Metra ◽  
Beth A. Davison ◽  
Guillaume Jondeau ◽  
John G.F. Cleland ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Acute Heart Failure ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Heart Failure Admission

scholarly journals Association of Blood Pressure Classification Using the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline with Risk of Heart Failure and Atrial Fibrillation

Circulation ◽  
2021 ◽  
Author(s):  
Hidehiro Kaneko ◽  
Yuichiro Yano ◽  
Hidetaka Itoh ◽  
Kojiro Morita ◽  
Hiroyuki Kiriyama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Cox Proportional Hazards ◽  
Health Claims ◽  
Claims Database ◽  
Stage 1

Background: Heart failure (HF) and atrial fibrillation (AF) are growing in prevalence worldwide. Few studies have assessed to what extent stage 1 hypertension in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) blood pressure (BP) guidelines is associated with incident HF and AF. Methods: Analyses were conducted using a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2018 (n=2,196,437; mean age, 44.0±10.9 years; 584% men). No participants were taking antihypertensive medication or had a known history of cardiovascular disease. Each participant was categorized as having normal BP (systolic BP [SBP]<120 mm Hg and diastolic BP [DBP]<80 mm Hg; n=1,155,885); elevated BP (SBP 120-129 mm Hg and DBP<80 mm Hg; n=337,390); stage 1 hypertension (SBP 130-139 mm Hg or DBP 80-89 mm Hg; n=459,820); or stage 2 hypertension (SBP≥140 mm Hg or DBP≥90 mm Hg; n=243,342). Using Cox proportional hazards models, we identified associations between BP groups and HF/AF events. We also calculated the population attributable fractions (PAFs) to estimate the proportion of HF and AF events that would be preventable if participants with stage 1 and stage 2 hypertension were to have normal BP. Results: Over a mean follow-up of 1,112±854 days, 28,056 incident HF and 7,774 incident AF events occurred. After multivariable adjustment, hazard ratios for HF and AF events were 1.10 (95% Confidence interval [CI], 1.05-1.15) and 1.07 (95% CI, 0.99-1.17), respectively, for elevated BP; 1.30 (95% CI, 1.26-1.35) and 1.21 (95% CI, 1.13-1.29), respectively, for stage 1 hypertension; and 2.05 (95% CI, 1.97-2.13) and 1.52 (95% CI, 1.41-1.64), respectively, for stage 2 hypertension vs normal BP. PAFs for HF associated with stage 1 and stage 2 hypertension were 23.2% (95% CI, 20.3%-26.0%) and 51.2% (95% CI, 49.2%-53.1%), respectively. The PAFs for AF associated with stage 1 and stage 2 hypertension were 17.4% (95% CI, 11.5%-22.9%) and 34.3% (95% CI, 29.1%-39.2%), respectively. Conclusions: Both stage 1 and stage 2 hypertension were associated with a greater incidence of HF and AF in the general population. The ACC/AHA BP classification system may help identify adults at higher risk for HF and AF events.

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