Abstract:
BACKGROUND AND OBJECTIVE:The association of an exaggerated systolic blood pressure increase with exercise (EBPIE) with cardiovascular events remains controversial. Our aim was to determine the possible association of an EBPIE with survival and risk of serious cardiac events in patients with hypertension and known or suspected coronary artery disease (CAD). PATIENTS AND METHODS:This is a retrospective observational study based on a sample of 5226 patients with a history of arterial hypertension and known or suspected CAD referred for exercise echocardiography. The EBPIE was defined as an increase in systolic blood pressure with exercise greater than or equal to the 95th percentile of this population (80mmHg). The end points were all-cause mortality, cardiac death and myocardial infarction (MI). RESULTS:During a mean follow-up of 4.7 years, there were 978 deaths (including 371 cardiac) and 798 MI. Annual rates of all-cause mortality, cardiac mortality and MI were 2.73, 0.83 and 2.63% in patients with EBPIE and 4.4, 1.58 and 3.98% in those without EBPIE (P<.001, P=.012, and P=.014, respectively). After multivariate analysis, an EBPIE remained independently associated with a lower risk of all-cause mortality (HR: 0.70, 95% CI: 0.52-0.95; P=.023) and MI (HR: 0.69, 95% CI: 0.50-0.95; P=.022) but was not significantly associated with cardiac mortality (HR: 0.72, 95% CI: 0.43-1.20; P=.2). CONCLUSIONS:EBPIE was associated with an increased likelihood of survival and lower rate of MI in hypertensive patients with known or suspected CAD.
journal_name
Med Clin (Barc)journal_title
Medicina clinicaauthors
Bouzas-Mosquera C,Bouzas-Mosquera A,Peteiro Jdoi
10.1016/j.medcli.2016.09.016subject
Has Abstractpub_date
2017-01-20 00:00:00pages
51-56issue
2eissn
0025-7753issn
1578-8989pii
S0025-7753(16)30425-0journal_volume
148pub_type
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