Low admission blood pressure as a marker of poor 1-year survival in patients with revascularized critical limb ischemia.
Journal
Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
pubmed:
13
3
2021
medline:
16
10
2021
entrez:
12
3
2021
Statut:
ppublish
Résumé
To contrast the association between blood pressure (BP) level and antihypertensive medications at hospital admission with 1-year mortality in patients undergoing revascularization for critical limb ischemia (CLI). From November 2013 to May 2019, 315 consecutive patients were retrospectively included. A median of seven (IQR 3-13) separate readings were recorded for each patient before revascularization procedure and the average represented patient's mean BP. BP-lowering medications, clinical and biological parameters were recorded at baseline. The main outcome was total 1-year mortality. The cohort included 172 men (55%) and 143 women (45%), with a mean age of 77.9 ± 11.9 years. Treated hypertension was present in 245 (78%) patients; 288 (91%) patients had BP-lowering drug prescriptions (2.1 ± 1.3 medications at baseline). Mean SBP, DBP, mean BP (MBP) and pulse pressure (PP) were 132 ± 18, 70 ± 8, 90 ± 10 and 62 ± 16mmHg. During 1-year follow-up, 80 (25.4%) patients died. In single-pressure multivariate analysis, SBP (hazard ratio 0.97; 95% CI 0.96-0.99; P = 0.005), MBP (hazard ratio 0.96; 95% CI 0.92-0.99; P = 0.01), PP (hazard ratio 0.97; 95% CI 0.95-0.99; P = 0.009), but not DBP, were inversely correlated with 1-year mortality, independently of age, coronary heart disease, left ventricular ejection fraction, brain natriuretic peptide, serum albumin, institutionalized status and antihypertensive drugs. Association between SBP, MBP and PP with 1-year mortality had a quite linear reverse pattern. Among patients undergoing revascularization for CLI, there is an inverse correlation between admission SBP, MBP and PP with 1-year mortality. BP may represent a modifiable therapeutic target to prevent poor outcome in CLI patients.
Identifiants
pubmed: 33710168
doi: 10.1097/HJH.0000000000002821
pii: 00004872-202108000-00017
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1611-1620Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Références
Suvila K, McCabe EL, Lehtonen A, Ebinger JE, Lima JAC, Cheng S, et al. Early onset hypertension is associated with hypertensive end-organ damage already by midlife. Hypertension 2019; doi: 10.1161/HYPERTENSIONAHA.119.13069.
doi: 10.1161/HYPERTENSIONAHA.119.13069
Wei J, Galaviz KI, Kowalski AJ, Magee MJ, Haw JS, Narayan KMV, Ali MK. Comparison of cardiovascular events among users of different classes of antihypertension medications: a systematic review and network meta-analysis. JAMA Netw Open 2020; 3:e1921618.
Franklin SS, Gokhale SS, Chow VH, Larson MG, Levy D, Vasan RS, et al. Does low diastolic blood pressure contribute to the risk of recurrent hypertensive cardiovascular disease events? The Framingham Heart Study. Hypertension 2015; 65:299–305.
Franklin SS, Lopez VA, Wong ND, Mitchell GF, Larson MG, Vasan RS, Levy D. Single versus combined blood pressure components and risk for cardiovascular disease. Circulation 2009; 119:243–250.
Yannoutsos A, Kheder-Elfekih R, Halimi JM, Safar ME, Blacher J. Should blood pressure goal be individualized in hypertensive patients? Pharmacol Res 2017; 118:53–63.
Roth D, Van Tulder R, Heidinger B, Herkner H, Schreiber W, Havel C. Admission blood pressure and 1-year mortality in acute myocardial infarction. Int J Clin Pract 2015; 69:812–819.
Stenestrand U, Wijkman M, Fredrikson M, Nystrom FH. Association between admission supine systolic blood pressure and 1-year mortality in patients admitted to the intensive care unit for acute chest pain. JAMA 2010; 303:1167–1172.
Constans J, Bura-Rivière A, Visona A, Brodmann M, Abraham P, Olinic DM, et al. Urgent need to clarify the definition of chronic critical limb ischemia - a position paper from the European Society for Vascular Medicine. Vasa 2019; 48:223–227.
Abu Dabrh AM, Steffen MW, Undavalli C, Asi N, Wang Z, Elamin MB, et al. The natural history of untreated severe or critical limb ischemia. J Vasc Surg 2015; 62:1642.e3–1651.e3.
Varu VN, Hogg ME, Kibbe MR. Critical limb ischemia. J Vasc Surg 2010; 51:230–241.
Cambou JP, Aboyans V, Constans J, Lacroix P, Dentans C, Bura A. Characteristics and outcome of patients hospitalised for lower extremity peripheral artery disease in France: the COPART Registry. Eur J Vasc Endovasc Surg 2010; 39:577–585.
Shiraki T, Iida O, Takahara M, Masuda M, Okamoto S, Ishihara T, et al. The Geriatric Nutritional Risk Index is independently associated with prognosis in patients with critical limb ischemia following endovascular therapy. Eur J Vasc Endovasc Surg 2016; 52:218–224.
Desormais I, Aboyans V, Bura A, Constans J, Cambou JP, Messas E, et al. Anemia, an independent predictive factor for amputation and mortality in patients hospitalized for peripheral artery disease. Eur J Vasc Endovasc Surg 2014; 48:202–207.
Yannoutsos A, Lin F, Billuart O, Gaisset R, Sacco E, Beaussier H, et al. Predictive value of admission blood pressure for 3-month mortality in patients undergoing revascularization for critical limb ischemia. J Hypertens 2020; 38:2409–2415.
Schulman S, Kearon C. Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in nonsurgical patients. J Thromb Haemost 2005; 3:692–694.
Jones CR, Taylor K, Poston L, Shennan AH. Validation of the Welch Allyn ’Vital Signs’ oscillometric blood pressure monitor. J Hum Hypertens 2001; 15:191–195.
Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 2006; 145:247–254.
Steg PG, Bhatt DL, Wilson PW, D’Agostino R Sr, Ohman EM, Röther J, et al. REACH Registry Investigators. One-year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007; 297:1197–1206.
Teng THK, Tay WT, Dahlstrom U, Benson L, Lam CSP, Lund LH. Different relationships between pulse pressure and mortality in heart failure with reduced, mid-range and preserved ejection fraction. Int J Cardiol 2018; 254:203–209.
Sigvant B, Kragsterman B, Falkenberg M, Hasvold P, Johansson S, Thuresson M, Nordanstig J. Contemporary cardiovascular risk and secondary preventive drug treatment patterns in peripheral artery disease patients undergoing revascularization. J Vasc Surg 2016; 64:1009.e3–1017.e3.
Schanzer A, Mega J, Meadows J, Samson RH, Bandyk DF, Conte MS. Risk stratification in critical limb ischemia: derivation and validation of a model to predict amputation-free survival using multicenter surgical outcomes data. J Vasc Surg 2008; 48:1464–1471.
Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, et al. Editor's Choice - 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018; 55:305–368.
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, et al. GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS). Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur J Vasc Endovasc Surg 2019; 58:S1.e33–S109.e33.
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71:1269–1324.
Vidal-Petiot E, Ford I, Greenlaw N, Ferrari R, Fox KM, Tardif JC, et al. CLARIFY Investigators. Cardiovascular event rates and mortality according to achieved systolic and diastolic blood pressure in patients with stable coronary artery disease: an international cohort study. Lancet 2016; 388:2142–2152.
Manapurathe TD, Moxon JV, Krishna SM, Rowbotham S, Quigley F, Jenkins J, et al. Cohort study examining the association between blood pressure and cardiovascular events in patients with peripheral artery disease. J Am Heart Assoc 2019; 8:e010748.
Itoga NK, Tawfik DS, Lee CK, Maruyama S, Leeper NJ, Chang TI. Association of blood pressure measurements with peripheral artery disease events. Circulation 2018; 138:1805–1814.
Bavry AA, Anderson RD, Gong Y, Denardo SJ, Cooper-Dehoff RM, Handberg EM, Pepine CJ. Outcomes Among hypertensive patients with concomitant peripheral and coronary artery disease: findings from the INternational VErapamil-SR/Trandolapril STudy. Hypertension 2010; 55:48–53.
Mourad JJ, Danchin N, Rudnichi A, Lopez-Sublet M, Le Jeune S, Safar ME. ESCAPP investigators. Aortic pulse pressure and atherosclerotic structural alterations of coronary arteries. J Hum Hypertens 2010; 24:51–57.
Shiraki T, Iida O, Takahara M, Okamoto S, Kitano I, Tsuji Y, et al. Predictive scoring model of mortality after surgical or endovascular revascularization in patients with critical limb ischemia. J Vasc Surg 2014; 60:383–389.
Wang JG, Staessen JA, Franklin SS, Fagard R, Gueyffier F. Systolic and diastolic blood pressure lowering as determinants of cardiovascular outcome. Hypertension 2005; 45:907–913.
Sheppard JP, Burt J, Lown M, Temple E, Lowe R, Fraser R, et al. OPTIMISE Investigators. Effect of antihypertensive medication reduction vs usual care on short-term blood pressure control in patients with hypertension aged 80 years and older: the OPTIMISE Randomized Clinical Trial. JAMA 2020; 323:2039–2051.
Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342:145–153.
Schanzer A, Hevelone N, Owens CD, Beckman JA, Belkin M, Conte MS. Statins are independently associated with reduced mortality in patients undergoing infrainguinal bypass graft surgery for critical limb ischemia. J Vasc Surg 2008; 47:774–781.
Baubeta Fridh E, Andersson M, Thuresson M, Sigvant B, Kragsterman B, Johansson S, et al. Amputation rates, mortality, and preoperative comorbidities in patients revascularised for intermittent claudication or critical limb ischaemia: a population based study. Eur J Vasc Endovasc Surg 2017; 54:480–486.
Klaphake S, de Leur K, Mulder PG, Ho GH, de Groot HG, Veen EJ, et al. Mortality after major amputation in elderly patients with critical limb ischemia. Clin Interv Aging 2017; 12:1985–1992.
Stern JR, Wong CK, Yerovinkina M, Spindler SJ, See AS, Panjaki S, et al. A meta-analysis of long-term mortality and associated risk factors following lower extremity amputation. Ann Vasc Surg 2017; 42:322–327.
Yannoutsos A, Dreyfuss Tubiana C, Safar ME, Blacher J. Optimal blood pressure target in stroke prevention. Curr Opin Neurol 2017; 30:8–14.
Volpe M, Giovanna Gallo G. Systolic blood pressure target less than 120 mmHg: the ’Chariot Allegory’ in hypertension? J Hypertens 2020; 38:1462–1463.