Cohort study examining the association between blood pressure and cardiovascular events in patients with peripheral artery disease
Thomas Manapurathe, Diana, Moxon, Joseph Vaughan, Krishna, Smriti Murali, Rowbotham, Sophie, Quigley, Frank, Jenkins, Jason, Bourke, Michael, Bourke, Bernard, Jones, Rhondda E., and Golledge, Jonathan (2019) Cohort study examining the association between blood pressure and cardiovascular events in patients with peripheral artery disease. Journal of the American Heart Association, 8. e010748.
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Abstract
Background-—Hypertension is an important risk factor for cardiovascular events in patients with peripheral artery disease; however, optimal blood pressure targets for these patients are poorly defined. This study investigated the association between systolic blood pressure (SBP) and cardiovascular events in a prospectively recruited patient cohort with peripheral artery disease.
Methods and Results-—A total of 2773 patients were included and were grouped according to SBP at recruitment (≤120 mm Hg, n=604; 121–140 mm Hg, n=1065; and >140 mm Hg, n=1104). Adjusted Cox proportional hazards analyses suggested that patients with SBP ≤120 mm Hg were at greater risk of having a major cardiovascular event (myocardial infarction, stroke, or cardiovascular death) than patients with SBP of 121–140 mm Hg (adjusted hazard ratio, 1.36; 95% CI, 1.08–1.72; P=0.009). Patients with SBP >140 mm Hg had an adjusted hazard ratio of 1.23 (95% CI, 1.00–1.51; P=0.051) of major cardiovascular events compared with patients with SBP of 121–140 mm Hg. These findings were similar in sensitivity analyses only including patients receiving antihypertensive medications or focused on patients with a minimum of 3 months of follow-up.
Conclusions-—This cohort study suggests that patients with peripheral artery disease and SBP ≤120 mm Hg are at increased risk of major cardiovascular events. The findings suggest caution in intensive SBP lowering in this patient group.
| Item ID: | 57942 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 2047-9980 |
| Keywords: | myocardial infarction; peripheral artery disease; major adverse cardiac event; blood pressure; stroke |
| Copyright Information: | Copyright © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (4.0), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
| Funders: | National Health and Medical Research Council (NHMRC), Queensland Government, James Cook University |
| Projects and Grants: | NHMRC grants 1063476 and 1000967, NHMRC Practitioner Fellowship 1117061, JCU Postgraduate Research Scholarship, JCU College of Medicine and Dentistry Scholarship |
| Date Deposited: | 22 Nov 2019 03:02 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 100% |
| SEO Codes: | 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100% |
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