Sökning: WFRF:(Fedorowski Artur)
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Directionality of b...
Directionality of blood pressure response to standing may determine development of heart failure: prospective cohort study.
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- Fedorowski, Artur (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups
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- Hedblad, Bo (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups
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- Engström, Gunnar (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups
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- Melander, Olle (författare)
- Lund University,Lunds universitet,Kardiovaskulär forskning - hypertoni,Forskargrupper vid Lunds universitet,Cardiovascular Research - Hypertension,Lund University Research Groups
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(creator_code:org_t)
- 2014-02-18
- 2011
- Engelska.
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Ingår i: European Journal of Heart Failure. - : Wiley. - 1879-0844 .- 1388-9842. ; 13, s. 496-503
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http://www.ncbi.nlm....
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- AIMS: To study the prospective relationship of blood pressure response during orthostatic challenge with incidence of heart failure (HF). METHODS AND RESULTS: In a Swedish prospective cohort study (the Malmö Preventive Project), we followed up 32 669 individuals (68.2% men; mean age, 46 years) over a period of 24 years. Incidence of first hospitalization due to new-onset HF was related to early (60-120 s) postural changes in systolic and diastolic blood pressure (ΔSBP and ▵DBP), and mean arterial pressure (ΔMAP), using Cox proportional hazards models. Hazard ratio of incident HF increased across descending quartiles of ΔSBP from the first (and reference) quartile (+8.5 ± 4.9 mmHg), through the second (neutral response), to the third and fourth quartiles (-5.0 ± 0.1 and -13.7 ± 6.1 mmHg, respectively; P for linear trend=0.009). A pronounced hypotensive SBP response (fourth quartile) conferred the highest risk of new-onset HF [hazard ratio (HR), 1.31; 95% confidence interval (CI), 1.11-1.53]. A similar pattern was observed with regard to ΔMAP, where the first (and reference) quartile with a marked positive MAP response (+7.7 ± 3.1 mmHg) had the lowest, and the fourth quartile with a hypotensive MAP response (-5.2 ± 3.4 mmHg) had the highest HF risk (HR for fourth vs. first quartile: 1.37; 95% CI, 1.17-1.62). In a continuous model, the risk of incident HF conferred by negative ΔSBP matched that of resting SBP (HR per 10 mmHg difference: 1.17; 95% CI, 1.11-1.23, and 1.17, 1.14-1.20, respectively), whereas MAP drop was the strongest individual predictor of HF development (HR 1.26, 95% CI, 1.21-1.31). CONCLUSION: Early increase of blood pressure in response to orthostatic challenge signals reduced the risk of HF development.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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