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Sökning: onr:"swepub:oai:lup.lub.lu.se:fc0dc818-b12d-405f-a66b-13c0d7d3a303" > Assessing optimal b...

Assessing optimal blood pressure in patients with asymptomatic aortic valve stenosis

Nielsen, Olav W. (författare)
Copenhagen University Hospital
Sajadieh, Ahmad (författare)
Copenhagen University Hospital
Sabbah, Muhammad (författare)
Copenhagen University Hospital
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Greve, Anders M. (författare)
Copenhagen University Hospital
Olsen, Michael H. (författare)
Odense University Hospital
Boman, Kurt (författare)
Umeå University
Nienaber, Christoph A. (författare)
Universitätsmedizin Rostock
Kesäniemi, Y. Antero (författare)
University of Oulu,Oulu University Hospital
Pedersen, Terje R. (författare)
Oslo university hospital
Willenheimer, Ronnie (författare)
Skåne University Hospital
Wachtell, Kristian (författare)
Oslo university hospital
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 (creator_code:org_t)
Lippincott Williams and Wilkins, 2016-08-09
Engelska 14 s.
Ingår i: Circulation. - : Lippincott Williams and Wilkins. - 0009-7322. ; 134:6, s. 455-468
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: Evidence for treating hypertension in patients with asymptomatic aortic valve stenosis is scarce. We used data from the SEAS trial (Simvastatin Ezetimibe in Aortic Stenosis) to assess what blood pressure (BP) would be optimal. Methods: A total of 1767 patients with asymptomatic aortic stenosis and no manifest atherosclerotic disease were analyzed. Outcomes were all-cause mortality, cardiovascular death, heart failure, stroke, myocardial infarction, and aortic valve replacement. BP was analyzed in Cox models as the cumulative average of serially measured BP and a time-varying covariate. Results: The incidence of all-cause mortality was highest for average follow-up systolic BP ≥160 mm Hg (4.3 per 100 person-years; 95% confidence interval [CI], 3.1-6.0) and lowest for average systolic BP of 120 to 139 mm Hg (2.0 per 100 person-years; 95% CI, 1.6-2.6). In multivariable analysis, all-cause mortality was associated with average systolic BP <120 mm Hg (hazard ratio [HR], 3.4; 95% CI, 1.9-6.1), diastolic BP ≥90 mm Hg (HR, 1.8; 95% CI, 1.1-2.9), and pulse pressure <50 mm Hg (HR, 1.8; 95% CI, 1.1-2.9), with systolic BP of 120 to 139 mm Hg, diastolic BP of 70 to 79 mm Hg, and pulse pressure of 60 to 69 mm Hg taken as reference. Low systolic and diastolic BPs increased risk in patients with moderate aortic stenosis. With a time-varying systolic BP from 130 to 139 mm Hg used as reference, mortality was increased for systolic BP ≥160 mm Hg (HR, 1.7; P=0.033) and BP of 120 to 129 mm Hg (HR, 1.6; P=0.039). Conclusions: Optimal BP seems to be systolic BP of 130 to 139 mm Hg and diastolic BP of 70 to 90 mm Hg in these patients with asymptomatic aortic stenosis and no manifest atherosclerotic disease or diabetes mellitus. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

aortic valve stenosis
blood pressure
hypertension
mortality
prognosis

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