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Antihypertensive tr...
Antihypertensive treatment with β-blockade in patients with asymptomatic aortic stenosis and association with cardiovascular events
- Article/chapterEnglish2017
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Wiley-Blackwell Publishing Inc.2017
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:umu-144421
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-144421URI
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https://doi.org/10.1161/JAHA.117.006709DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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.
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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, KurtUmeå universitet,Medicin(Swepub:umu)kubo0001
(author)
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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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Umeå universitetMedicin
(creator_code:org_t)
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In:Journal of the American Heart Association: Wiley-Blackwell Publishing Inc.6:122047-9980
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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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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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- 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 ...
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Journal of the A ...
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Umeå University