Cargando…

Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease

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 e...

Descripción completa

Detalles Bibliográficos
Autores principales: Thomas Manapurathe, Diana, Moxon, Joseph Vaughan, Krishna, Smriti Murali, Rowbotham, Sophie, Quigley, Frank, Jenkins, Jason, Bourke, Michael, Bourke, Bernard, Jones, Rhondda E., Golledge, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475052/
https://www.ncbi.nlm.nih.gov/pubmed/30845872
http://dx.doi.org/10.1161/JAHA.118.010748
_version_ 1783412702934204416
author Thomas Manapurathe, Diana
Moxon, Joseph Vaughan
Krishna, Smriti Murali
Rowbotham, Sophie
Quigley, Frank
Jenkins, Jason
Bourke, Michael
Bourke, Bernard
Jones, Rhondda E.
Golledge, Jonathan
author_facet Thomas Manapurathe, Diana
Moxon, Joseph Vaughan
Krishna, Smriti Murali
Rowbotham, Sophie
Quigley, Frank
Jenkins, Jason
Bourke, Michael
Bourke, Bernard
Jones, Rhondda E.
Golledge, Jonathan
author_sort Thomas Manapurathe, Diana
collection PubMed
description 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.
format Online
Article
Text
id pubmed-6475052
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-64750522019-04-24 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. Golledge, Jonathan J Am Heart Assoc Original Research 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. John Wiley and Sons Inc. 2019-03-08 /pmc/articles/PMC6475052/ /pubmed/30845872 http://dx.doi.org/10.1161/JAHA.118.010748 Text en © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, 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.
spellingShingle Original Research
Thomas Manapurathe, Diana
Moxon, Joseph Vaughan
Krishna, Smriti Murali
Rowbotham, Sophie
Quigley, Frank
Jenkins, Jason
Bourke, Michael
Bourke, Bernard
Jones, Rhondda E.
Golledge, Jonathan
Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease
title Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease
title_full Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease
title_fullStr Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease
title_full_unstemmed Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease
title_short Cohort Study Examining the Association Between Blood Pressure and Cardiovascular Events in Patients With Peripheral Artery Disease
title_sort cohort study examining the association between blood pressure and cardiovascular events in patients with peripheral artery disease
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475052/
https://www.ncbi.nlm.nih.gov/pubmed/30845872
http://dx.doi.org/10.1161/JAHA.118.010748
work_keys_str_mv AT thomasmanapurathediana cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT moxonjosephvaughan cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT krishnasmritimurali cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT rowbothamsophie cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT quigleyfrank cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT jenkinsjason cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT bourkemichael cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT bourkebernard cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT jonesrhonddae cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease
AT golledgejonathan cohortstudyexaminingtheassociationbetweenbloodpressureandcardiovasculareventsinpatientswithperipheralarterydisease