Influence of systolic blood pressure on outcomes in Nigerians with peripartum cardiomyopathy

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Influence of systolic blood pressure on outcomes in Nigerians with peripartum cardiomyopathy

Sa'idu, H. (författare): Department of Medicine, Bayero University; Department of Medicine, Murtala Mohammed Specialist Hospital, Kano, Nigeria

Balarabe, S.A. (författare): Department of Medicine, Muhammad Abdullahi Wase Specialist Hospital, Kano, Nigeria

Ishaq, N.A. (författare): Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria

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Adamu, U.G. (författare): Department of Medicine, Federal Medical Center Bidda, Nigeria

Mohammed, I.Y. (författare): Department of Chemical Pathology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria

Oboirien, I. (författare): Department of Medicine, Dalhatu Araf Specialist Hospital, Lafia, Nigeria

Umuerri, E.M. (författare): Department of Medicine, Delta State University Teaching Hospital, Nigeria

Mankwe, A.C. (författare): Department of Medicine, Federal Medical Center Yenagoa, Yenagoa, Nigeria

Shidali, V.Y. (författare): Department of Medicine, Federal Medical Center Keffi, Keffi, Nigeria

Njoku, P. (författare): Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria

Dodiyi-Manuel, S. (författare): Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Olunuga, T. (författare): Department of Medicine, Federal Medical Center Abeokuta, Abeokuta, Nigeria

Josephs, V. (författare): Department of Medicine, University of Benin Teaching Hospital, Nigeria

Mbakwem, A.C. (författare): Department of Medicine, University of Lagos Teaching Hospital, Lagos, Nigeria

Okolie, H. (författare): Department of Medicine, Federal Teaching Hospital, Gombe, Nigeria

Talle, M.A. (författare): Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria

Isa, M.S. (författare): Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Adebayo, R.A. (författare): Department of Medicine, Obafemi Awolowo University Teaching Hospital, Nigeria

Tukur, J. (författare): Department of Medicine, Bayero University, Kano, Nigeria

Isezuo, S.A. (författare): Department of Medicine, Usman Danfodio University Teaching Hospital, Sokoto, Nigeria

Umar, H. (författare): Department of Medicine, Usman Danfodio University Teaching Hospital, Sokoto, Nigeria

Shehu, M.N. (författare): Department of Medicine, General Ahmadi Kurfi Specialist Hospital, Katsina, Nigeria

Ogah, O.S. (författare): Department of Medicine, University College Hospital, Ibadan; Institute of Advanced Medical Research and Training, University of Ibadan, Nigeria

Karaye, Kamilu Musa (författare): Umeå universitet,Institutionen för folkhälsa och klinisk medicin,Department of Medicine, Bayero University, Nigeria; Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria; Hatter Institute for Cardiovascular Research in Africa, Capetown, South Africa

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Wolters Kluwer, 2022
2022
Engelska.
Ingår i: Nigerian Journal of Clinical Practice. - : Wolters Kluwer. - 1119-3077 .- 2229-7731. ; 25:12, s. 1963-1968

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Background: The relationship between blood pressure (BP) trajectories and outcomes in patients with peripartum cardiomyopathy (PPCM) is not clear.Aim: The study aimed to assess the clinical features and outcomes (all-cause mortality and unrecovered left ventricular [LV] systolic function) of PPCM patients grouped according to their baseline systolic BP (SBP).Patients and Methods: PPCM patients presenting to 14 tertiary hospitals in Nigeria were consecutively recruited between June 2017 and March 2018 and then followed up till March 2019. SBP at first presentation was used to categorize the patients into seven groups: <90, 90-99, 100-109, 110-119, 120-129, 130-139, and ≥140 mmHg. Unrecovered LV systolic function was defined as echocardiographic LV ejection fraction (LVEF) below 55% at the last profiling.Results: Two hundred and twenty-seven patients were recruited and followed up for a median of 18 months. Of these, 4.0% had <90 mmHg, 16.3% had 90-99 mmHg, 24.7% had 100-109 mmHg, 24.7% had 110-119 mmHg, 18.5% had 120-129 mmHg, 7.5% had 130-139 mmHg, and 4.4% had ≥140 mmHg of SBP at presentation. The highest frequency of all-cause mortality was recorded among patients with SBP ≤90 mmHg (30.8%) followed by those with 90-99 mmHg (20.5%) (P = 0.076), while unrecovered LV systolic function did not differ significantly between the groups (P = 0.659). In a Cox proportional regression model for all-cause mortality, SBP <90 mmHg had a hazard ratio (HR) of 4.00 (95% confidence interval [CI] 1.49-10.78, P = 0.006), LVEF had an HR of 0.94 (95% CI 0.91-0.98, P = 0.003, B = 0.06%), and use of angiotensin-converting enzyme or angiotensin receptor and/or β-receptor blockers had an HR of 1.71 (95% CI 0.93-3.16, P = 0.085). However, SBP was not associated with LV function recovery.Conclusion: In our cohort of PPCM patients, one-fifth was hypotensive at presentation. SBP <90 mmHg at presentation was associated with a four-fold higher risk of all-cause mortality during a median follow-up of 18 months.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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Av lärosätet: Umeå universitet

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Influence of systolic blood pressure on outcomes in Nigerians with peripartum cardiomyopathy

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