scholarly journals Reverse J-Curve Relation between Diastolic Blood Pressure and Severity of Coronary Artery Lesion in Hypertensive Patients with Angina Pectoris.

2002 ◽  
Vol 25 (3) ◽  
pp. 381-387 ◽  
Author(s):  
Naoyuki HASEBE ◽  
Shinsuke KIDO ◽  
Akira IDO ◽  
Kenjiro KIKUCHI
Keyword(s):  
Blood Pressure ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Diastolic Blood Pressure ◽  
Coronary Artery Lesion ◽  
Hypertensive Patients ◽  
J Curve

Abstract 031: Diastolic Blood Pressure, Coronary Artery Calcium, and Cardiac Outcomes in the Multi-ethnic Study of Atherosclerosis

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
John W McEvoy ◽  
Faisal Rahman ◽  
Mahmoud Al Rifai ◽  
Michael Blaha ◽  
Khurram Nasir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Confidence Interval ◽  
Diastolic Blood Pressure ◽  
Coronary Artery Calcium ◽  
J Curve ◽  
Increased Risk ◽  
All Cause Mortality

Diastolic blood pressure (BP) has a J-curve relationship with coronary heart disease and death. Because this association is thought to reflect reduced coronary perfusion at low diastolic BP, our objective was to test whether the J-curve is most pronounced among persons with coronary artery calcium. Among 6,811 participants from the Multi-Ethnic Study of Atherosclerosis, we used Cox models to examine if diastolic BP category is associated with coronary heart disease events, stroke, and mortality. Analyses were conducted in the sample overall and after stratification by coronary artery calcium score. In multivariable-adjusted analyses, compared with diastolic BP of 80 to 89 mmHg (reference), persons with diastolic BP <60 mmHg had increased risk of coronary heart disease events (HR 1.69 [95% confidence interval 1.02-2.79]) and all-cause mortality (HR 1.48 [95% confidence interval 1.10-2.00]), but not stroke. After stratification, associations of diastolic BP <60 mmHg with events were present only among participants with coronary artery calcium >0. Diastolic BP <60 mmHg was not associated with events when coronary artery calcium was zero. We also found no interaction in the association between low diastolic BP and events based on race. In conclusion, diastolic blood pressure <60 mmHg was associated with increased risk of coronary heart disease events and all-cause mortality in the sample overall, but this association appeared strongest among individuals with elevated CAC; suggesting that added caution may be needed when pursuing intensive BP treatment targets among persons with subclinical atherosclerosis.

scholarly journals 430 Relation of blood pressure to coronary artery calcium and mortality

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I J Cho ◽  
J H Lee ◽  
S Y Choi ◽  
E J Chun ◽  
S H Park ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery ◽  
Diastolic Blood Pressure ◽  
Coronary Artery Calcium ◽  
Multicenter Observational Study ◽  
J Curve ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Study Population ◽  
Artery Disease

Abstract Background Diastolic blood pressure has a J-curve relation with coronary heart disease and death, but it is debating whether a J-curve association exists in general population. We aimed to assess the relation of blood pressure to mortality, and whether their association is interacted with presence of high coronary artery calcium (CAC). Methods The KOICA registry is a retrospective, multicenter observational study designed to investigate the effectiveness and prognostic value of CAC score for primary prevention of cardiovascular disease in asymptomatic Korean adults. The association between CAC score and blood pressure was assessed. Patients were divided into 2 groups according to the baseline CACS (&gt; 300 and ≤ 300), and all-cause mortality was assessed. Results The study population composed 48903 subjects with a mean age of 54 ± 9. There were 425 (0.9%) deaths during follow-up. At baseline, SBP (systolic blood pressure) more than 110 mmHg and DBP (diastolic blood pressure) more than 80 mmHg was associated with increased risk for CACS &gt; 300. In patients with baseline CACS ≤ 300, all-cause mortality was increased in patients with SBP of 110-119 mmHg (HR 1.47, p = 0.023), 130-139 mmHg (HR 1.72, p = 0.002) and ≥ 140 mmHg (HR 1.47, p = 0.042) compared to SBP of 120-129 mmHg, whereas DBP did not predict all-cause mortality. In contrast, SBP was not associated to all-cause mortality in patients with CACS &gt; 300, whereas DBP &lt; 60 mmHg (HR 3.53, p =0.018) and 70-79 mmHg (HR 2.21, p = 0.042) was associated with increased risk for all-cause mortality compared to DBP of 80-89 mmHg. Conclusion Low DBP was associated with increased risk for all-cause mortality in subjects with high CAC score, suggesting high-risk for coronary artery disease. However, this J-curve relation was not shown in the population with low CAC score.

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.

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

ASSESSING THE OUTCOMES OF TREATMENT AND MANAGEMENT, 400 HYPERTENSIVE PATIENTS IN BONG SON GENERAL HOSPITAL, BINH DINH PROVINCE

2016 ◽  
pp. 31-40
Author(s):  
Long Nhon Phan ◽  
Van Minh Huynh ◽  
Thi Kim Nhung Hoang ◽  
Van Nham Truong
Keyword(s):  
Blood Pressure ◽  
Risk Stratification ◽  
Hypertensive Patient ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Target ◽  
Average Risk ◽  
Hypertensive Patients ◽  
Average Systolic Blood Pressure ◽  
Complications Of Stroke

Objective: To evaluate the results of treatment achieved blood pressure goal (BP goal) and results of hypertensive patient management. Subjects and methods: A study of 400 hypertensive patient intervention, treatment and management after 2 year. To assess the results of BP target, monitor the use of medicines, the situation of hospitalization and complications of stroke. Results: Treatment: -100% of patients using diuretics and angiotensin-converting enzyme inhibitors (ACEIs), 33% of patients using angiotensin receptor blockers (ARBs), 46.25% of patients using calcium channel blockers (CCBs) and 19.5% of patients using beta-blocker. After 24 months of treatment: 50.5% of patients using 1 antihypertensive drug, 22% of patients using 2 drugs, 20.5% of patients using 3 drugs and 7% of patients taking more than 3 drugs. After 24 months of treatment: 91.75% achieved BP target and 8.25% fail. -Average risk stratification: 97.32% achieved BP target, hight risk stratification: 95.91% and very hight risk stratification: 73.03%. After 24 months of treatment. -Stage 1: 88.48% achieved BP target, stage 2: 92.85% achieved BP target and stage 3: 71.08% achieved BP target. After 24 months of treatment. -Hypertesive results before treatment were: 159.80 ± 20,22mmHg average systolic blood pressure and 82.97 ± 5,82mmHg average diastolic blood pressure. After treatment: average systolic blood pressure 125.38 ± 6,88mmHg and average diastolic blood pressure 79.83 ± 1,79mmHg. No adverse change in the index of tests about lipidemia, liver, kidney, glucomia and no recorded cases of drug side effects. Management of patients: -There were 89% non-medical examinational patients 1 month, 5.25% non-medical examinational patients 2 months, 4.25% non-medical examinational patients 3 months and 1.5% non-medical examinational patients 4 months. There were 93.5% drop pill 1 month, 3.25% drop pill 2 months, 4.25% drop pill 3 months and no patient drop pill over 3 months. In 24 months follow-up, 47% hospitalized inpatients <5 times, 44.5% hospitalized inpatients 5-10 times, 3% hospitalized inpatients 11-15 times, 4.75% hospitalized inpatients from 16-20 times and 0.75% hospitalized inpatients > 20 times. -There were 32.75% hospitalized inpatients for reasons of hypertension and 63.75% hospitalized inpatients for other common diseases. -There were a total of 11592 contacts directly by phone for medical advice, medical reminders and examinational reminders during 24 months of management. -There were 0.5% of patients stroked during 24 months of treatment and management. Conclusion: Treatment by protocol and management by phone directly for medical taking and re-examinational reminders is the best resulted method of achieving blood pressure target and reducing complications of stroke for hypertensive patients. Key word: : blood pressure target; risk stratification; treatment; management; stage; phone.

scholarly journals Increased response of diastolic blood pressure to exercise in patients with coronary artery disease: an index of latent ventricular dysfunction?

Heart ◽  
1993 ◽  
Vol 69 (6) ◽  
pp. 507-511 ◽  
Author(s):  
I A Paraskevaidis ◽  
D T Kremastinos ◽  
A S Kassimatis ◽  
G K Karavolias ◽  
G D Kordosis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diastolic Blood Pressure ◽  
Ventricular Dysfunction ◽  
Artery Disease

scholarly journals Clinical Treatment Analysis and Imaging Study of Patients with Acute Angina in Cardiovascular Medicine

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Peng Li ◽  
Li He
Keyword(s):  
Blood Pressure ◽  
Angina Pectoris ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Medical Images ◽  
Treatment Method ◽  
Clinical Treatment ◽  
Control Group ◽  
Vessel Disease ◽  
Experimental Group

With the accelerating pace of life, increasing stress and unhealthy diet make cardiovascular disease one of the important diseases that endanger human health, among which the incidence of acute angina is gradually increasing. At present, there are many clinical treatment studies on acute angina pectoris, but the relevant imaging analysis is very lacking. In order to study the clinical treatment of patients with acute angina pectoris and analyze the relevant medical images, to arrive at a more effective treatment method, this article launched an in-depth study. First, we selected 88 patients with acute angina in a hospital as the research object and randomly divided them into a control group (n = 44) and an experimental group (n = 44) Yan et al. (2020). The control group was treated with conventional acute angina pectoris drugs, while the experimental group was treated with clopidogrel on this basis. The two groups were treated at the same time, and the treatment time lasted for 3 months. Then, the risk factors of the two groups of patients were analyzed, and the differences were statistically significant ( P < 0.05 ). Then, the medical images of the two groups of patients were analyzed, and the diastolic blood pressure, systolic blood pressure, and coronary artery stenosis were compared before and after treatment. After treatment, the diastolic blood pressure and systolic blood pressure of the experimental group were 88.31 ± 3.15 mmHg and 125.63 ± 4.16 mmHg, respectively. The proportion of patients with zero-vessel disease and single-vessel disease in the experimental group increased to 15.91% and 56.82%. The treatment plan received by the experimental group patients had a better improvement effect. Finally, the clinical efficacy was compared. The total effective rates of the control and experimental groups were 72.7% and 88.6%, respectively. This shows that the treatment method adopted by the experimental group of patients has a better curative effect and is worthy of clinical promotion.

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