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Antihypertensive tr...
Antihypertensive treatment with β-blockade in patients with asymptomatic aortic stenosis and association with cardiovascular events
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Bang, Casper N. (author)
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Greve, Anders M. (author)
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Rossebø, Anne B. (author)
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Ray, Simon (author)
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Egstrup, Kenneth (author)
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- Boman, Kurt (author)
- Umeå universitet,Medicin
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Nienaber, Christoph (author)
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Okin, Peter M. (author)
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Devereux, Richard B. (author)
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Wachtell, Kristian (author)
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(creator_code:org_t)
- Wiley-Blackwell Publishing Inc. 2017
- 2017
- English.
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In: Journal of the American Heart Association. - : Wiley-Blackwell Publishing Inc.. - 2047-9980. ; 6:12
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https://umu.diva-por... (primary) (Raw object)
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Abstract
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- Background: Patients with aortic stenosis (AS) often have concomitant hypertension. Antihypertensive treatment with a beta-blocker (Bbl) is frequently avoided because of fear of depression of left ventricular function. However, it remains unclear whether antihypertensive treatment with a Bbl is associated with increased risk of cardiovascular events in patients with asymptomatic mild to moderate AS.Methods and results: We did a post hoc analysis of 1873 asymptomatic patients with mild to moderate AS and preserved left ventricular ejection fraction in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study. Propensity-matched Cox regression and competing risk analyses were used to assess risk ratios for all-cause mortality, sudden cardiac death, and cardiovascular death. A total of 932 (50%) patients received Bbl at baseline. During a median follow-up of 4.3 +/- 0.9 years, 545 underwent aortic valve replacement, and 205 died; of those, 101 were cardiovascular deaths, including 40 sudden cardiovascular deaths. In adjusted analyses, Bbl use was associated with lower risk of all-cause mortality (hazard ratio 0.5, 95% confidence interval 0.3-0.7, P<0.001), cardiovascular death (hazard ratio 0.4, 95% confidence interval 0.2-0.7, P<0.001), and sudden cardiac death (hazard ratio 0.2, 95% confidence interval 0.1-0.6, P=0.004). This was confirmed in competing risk analyses (all P<0.004). No interaction was detected with AS severity (all P>0.1).Conclusions: In post hoc analyses Bbl therapy did not increase the risk of all-cause mortality, sudden cardiac death, or cardiovascular death in patients with asymptomatic mild to moderate AS. A prospective study may be warranted to determine if Bbl therapy is in fact beneficial.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- aortic valve stenosis
- arrhythmia (heart rhythm disorders)
- atrial fibrillation
- beta-blocker
- high blood essure
- hypertension
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Bang, Casper N.
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Greve, Anders M.
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Rossebø, Anne B.
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Ray, Simon
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Egstrup, Kenneth
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Boman, Kurt
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show more...
-
Nienaber, Christ ...
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Okin, Peter M.
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Devereux, Richar ...
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Wachtell, Kristi ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of the A ...
- By the university
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Umeå University