Per H Skoglund1, Jan Östergren, Per Svensson. 1. Karolinska University Hospital Solna, Department of Emergency Medicine, Stockholm, Sweden. per.skoglund@karolinska.se
Abstract
BACKGROUND: Patients with peripheral arterial disease (PAD) are at high risk of cardiovascular (CV) events and often have hypertension with a high pulse pressure (PP). We studied the prognostic value of ambulatory blood pressure (ABP) in PAD patients with special reference to PP. METHODS: 98 consecutive males with PAD had 24-h ABP measurements. The mean age was 68 years and CV comorbidity was prevalent. The outcome variable was CV events defined as CV mortality or any hospitalization for myocardial infarction, stroke or coronary revascularization. The predictive value of ABP variables was assessed by Cox regression. 90 age-matched men free of CV disease served as controls. RESULTS: During follow-up (median 71 months), 36 patients and seven controls had at least one CV event. In PAD patients, 24-h PP (hazard ratios, HR, 1.48 (95% confidence interval, CI, 1.14-1.92), p <0.01) predicted CV events. Office PP did not predict events in PAD patients (HR 1.15 (0.97-1.38), ns). In multivariate analysis, 24-h PP (HR 1.48 (1.12-1.95), p <0.01) remained a predictor of CV events. CONCLUSIONS: Ambulatory PP predicts CV events in patients with PAD. ABP measurement may be indicated for better risk stratification in PAD patients.
BACKGROUND:Patients with peripheral arterial disease (PAD) are at high risk of cardiovascular (CV) events and often have hypertension with a high pulse pressure (PP). We studied the prognostic value of ambulatory blood pressure (ABP) in PAD patients with special reference to PP. METHODS: 98 consecutive males with PAD had 24-h ABP measurements. The mean age was 68 years and CV comorbidity was prevalent. The outcome variable was CV events defined as CV mortality or any hospitalization for myocardial infarction, stroke or coronary revascularization. The predictive value of ABP variables was assessed by Cox regression. 90 age-matched men free of CV disease served as controls. RESULTS: During follow-up (median 71 months), 36 patients and seven controls had at least one CV event. In PAD patients, 24-h PP (hazard ratios, HR, 1.48 (95% confidence interval, CI, 1.14-1.92), p <0.01) predicted CV events. Office PP did not predict events in PAD patients (HR 1.15 (0.97-1.38), ns). In multivariate analysis, 24-h PP (HR 1.48 (1.12-1.95), p <0.01) remained a predictor of CV events. CONCLUSIONS: Ambulatory PP predicts CV events in patients with PAD. ABP measurement may be indicated for better risk stratification in PAD patients.
Authors: Oscar H Del Brutto; Robertino M Mera; Mark J Sedler; Jadry A Gruen; Kelsie J Phelan; Elizabeth H Cusick; Mauricio Zambrano; David L Brown Journal: High Blood Press Cardiovasc Prev Date: 2015-05-19
Authors: Sara L Zettervall; Dominique B Buck; Jeremy D Darling; Vanessa Lee; Marc L Schermerhorn; Raul J Guzman Journal: J Vasc Surg Date: 2015-11-11 Impact factor: 4.268
Authors: Michael Trapp; Eva-Maria Trapp; Josef W Egger; Wolfgang Domej; Giuseppe Schillaci; Alexander Avian; Peter M Rohrer; Nina Hörlesberger; Dieter Magometschnigg; Mila Cervar-Zivkovic; Peter Komericki; Rosemarie Velik; Johannes Baulmann Journal: PLoS One Date: 2014-05-09 Impact factor: 3.240
Authors: Päivi A Lempiäinen; Antti Ylitalo; Heikki Huikuri; Y Antero Kesäniemi; Olavi H Ukkola Journal: J Clin Hypertens (Greenwich) Date: 2021-07-03 Impact factor: 3.738