OBJECTIVE: To investigate the independent effects of antihypertensive treatment and blood pressure (BP) levels on physical and mental health status in patients with arterial disease. DESIGN AND SETTING: Cross-sectional analyses were conducted within the single-centre Secondary Manifestations of ARTerial disease (SMART) study, in a hospital care setting. SUBJECTS: A total of 5877 patients (mean age 57 years) with symptomatic and asymptomatic arterial disease underwent standardized vascular screening. MAIN OUTCOME MEASURE: The primary outcome was self-rated physical and mental health assessed using the 36-item short-form health survey. RESULTS: In the total population, antihypertensive drug use and increased intensity of antihypertensive treatment were associated with poorer health status independent of important confounders including BP levels; adjusted mean differences [95% confidence interval (CI)] in physical and mental health between n = 0 and n ≥ 3 antihypertensives were -1.2 (-2.1; -0.3) and -3.5 (-4.4; -2.6), respectively. Furthermore, both lower systolic and lower diastolic BP levels were related to poorer physical and mental health status independent of antihypertensive treatment. Mean differences (95% CI) in physical and mental health status per SD decrease in systolic BP were -0.56 (-0.84; -0.27) and -0.32 (-0.61; -0.03) and per SD decrease in diastolic BP were -0.50 (-0.78; -0.23) and -0.08 (-0.36; 0.20), respectively. The association between low BP and poor health status was particularly present in patients with coronary artery disease. CONCLUSIONS: In a population of patients with asymptomatic and symptomatic arterial disease, antihypertensive treatment and lower BP levels are independently associated with poorer self-rated physical and mental health. These findings suggest that different underlying mechanisms may explain these independent associations.
OBJECTIVE: To investigate the independent effects of antihypertensive treatment and blood pressure (BP) levels on physical and mental health status in patients with arterial disease. DESIGN AND SETTING: Cross-sectional analyses were conducted within the single-centre Secondary Manifestations of ARTerial disease (SMART) study, in a hospital care setting. SUBJECTS: A total of 5877 patients (mean age 57 years) with symptomatic and asymptomatic arterial disease underwent standardized vascular screening. MAIN OUTCOME MEASURE: The primary outcome was self-rated physical and mental health assessed using the 36-item short-form health survey. RESULTS: In the total population, antihypertensive drug use and increased intensity of antihypertensive treatment were associated with poorer health status independent of important confounders including BP levels; adjusted mean differences [95% confidence interval (CI)] in physical and mental health between n = 0 and n ≥ 3 antihypertensives were -1.2 (-2.1; -0.3) and -3.5 (-4.4; -2.6), respectively. Furthermore, both lower systolic and lower diastolic BP levels were related to poorer physical and mental health status independent of antihypertensive treatment. Mean differences (95% CI) in physical and mental health status per SD decrease in systolic BP were -0.56 (-0.84; -0.27) and -0.32 (-0.61; -0.03) and per SD decrease in diastolic BP were -0.50 (-0.78; -0.23) and -0.08 (-0.36; 0.20), respectively. The association between low BP and poor health status was particularly present in patients with coronary artery disease. CONCLUSIONS: In a population of patients with asymptomatic and symptomatic arterial disease, antihypertensive treatment and lower BP levels are independently associated with poorer self-rated physical and mental health. These findings suggest that different underlying mechanisms may explain these independent associations.
Authors: R H Grimm; G A Grandits; J A Cutler; A L Stewart; R H McDonald; K Svendsen; R J Prineas; P R Liebson Journal: Arch Intern Med Date: 1997-03-24
Authors: Lidia Glodzik; Henry Rusinek; Wai Tsui; Elizabeth Pirraglia; Hee-Jin Kim; Anup Deshpande; Yi Li; Pippa Storey; Catherine Randall; Jingyun Chen; Ricardo S Osorio; Tracy Butler; Emily Tanzi; Molly McQuillan; Patrick Harvey; Stephen K Williams; Gbenga Ogedegbe; James S Babb; Mony J de Leon Journal: Hypertension Date: 2019-01 Impact factor: 10.190
Authors: Lidia Glodzik; Henry Rusinek; Elizabeth Pirraglia; Pauline McHugh; Wai Tsui; Schantel Williams; Megan Cummings; Yi Li; Kenneth Rich; Catherine Randall; Lisa Mosconi; Ricardo Osorio; John Murray; Henrik Zetterberg; Kaj Blennow; Mony de Leon Journal: Neurobiol Aging Date: 2013-08-19 Impact factor: 4.673