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Relationship between the blood pressure and the long-term prognosis in a cohort of coronary patients
Session:
Posters (Sessão 1 - Écran 6) - DAC e Cuidados Intensivos 1 - Síndromes Coronários Crónicos
Speaker:
M. Raquel Santos
Congress:
CPC 2022
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.2 Coronary Artery Disease – Epidemiology, Prognosis, Outcome
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
m. Raquel Santos; Roberto Palma Dos Reis; Débora sá; Margarida Temtem; Ana Célia Sousa; Eva Henriques; Mariana Rodrigues; Sónia Freitas; Sofia Borges; Ilídio Ornelas; António Drumond; Maria Isabel Mendonça
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Introduction: </span></span></strong></span></span><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Recent studies emphasized strict blood pressure (BP) control for patients at high-risk for cardiovascular (CV) events. Although guidelines recommend a BP target of less than 130/80mmHg in individuals with stable ischemic heart disease, there are little data about the relationship between BP levels and prognosis in patients with coronary artery disease (CAD). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Purpose: </span></span></strong></span></span><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Evaluate the relationship between BP levels and CV mortality in a long-term follow-up of coronary patients.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Methods: </span></span></strong></span></span><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">1723 coronary patients (mean age 53.3±7.9 years, 78.7% male) were prospectively followed-up,<span style="color:black"> mean of 4.9±3.4 years (range 1 to 17 years).</span> This population was stratified according to systolic and diastolic BP into different levels: SBP <121 mmHg, 121-130 mmHg, 131-140 mmHg and >140 mmHg and DBP <71 mmHg, 71-80 mmHg, 81-90 mmHg and >90mmHg. The percentage of CV deaths were assigned into each BP level using Chi-squared test. A multivariate analysis with BP levels and other risk factors to CV mortality was performed.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Results: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">SBP levels <121 mmHg were associated with a high mortality rate (22%), decreasing as SBP gradually rises up to a threshold of 140 mmHg. From this point, mortality increases abruptly to about 46.0%, demonstrating a “J” shape according to SBP. A similar shape plot was verified for MACE occurrence. Multivariate analysis showed that SBP <121 and >140 mmHg were independent risk factors for mortality (p=0.004 and p=0.024, respectively). On the other hand, there was no statistically significant relationship between DBP and MACE or mortality.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Conclusion: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">SBP levels <121mmHg and >140mmHg, unlike DBP levels, were associated with a worse prognosis and increased mortality. According to this study, coronary patients with elevated BP should be recommended to lower systolic blood pressure to values within the range from 131mm Hg to 140 mmHg.</span></span></span></span></p>
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