Optimal blood pressure for patients with end-stage renal disease following coronary interventions

被引:0
作者
Yang, Ya-Ling [1 ,2 ]
Chen, Su-Chan [2 ,3 ]
Wu, Cheng-Hsueh [2 ,3 ]
Huang, Shao-Sung [2 ,3 ,4 ]
Chan, Wan Leong [2 ,3 ]
Lin, Shing-Jong [2 ,3 ]
Chou, Chia-Yu [2 ,3 ]
Chen, Jaw-Wen [2 ,3 ,4 ]
Ju-Pin, Pan [2 ,3 ]
Charng, Min-Ji [2 ,3 ]
Chen, Ying-Hwa [2 ,3 ]
Wu, Tao-Cheng [2 ,3 ]
Lu, Tse-Min [2 ,3 ,4 ]
Hsu, Pai-Feng [2 ,3 ]
Huang, Po-Hsun [2 ,3 ]
Cheng, Hao-Min [2 ,3 ]
Huang, Chin-Chou [2 ,3 ]
Sung, Shih-Hsien [2 ,3 ]
Lin, Yenn-Jiang [2 ,3 ]
Leu, Hsin-Bang [2 ,3 ,4 ,5 ,6 ]
机构
[1] Cardinal Tien Hosp, Div Cardiol, Dept Med, New Taipei, Taiwan
[2] Natl Yang Ming Chiao Univ, Sch Med, Dept Med, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med, Div Cardiol, 201,Sec 2,Shih Pai Rd, Taipei 112, Taiwan
[4] Taipei Vet Gen Hosp, Healthcare & Management Ctr, Taipei, Taiwan
[5] Natl Yang Ming Univ, Inst Clin Med, Taipei, Taiwan
[6] Natl Yang Ming Univ, Cardiovasc Res Ctr, Taipei, Taiwan
关键词
blood pressure; coronary artery disease; end-stage renal disease; percutaneous coronary intervention; TAIWAN HYPERTENSION; ASSOCIATION; GUIDELINES; SOCIETY; HYPOTENSION; MANAGEMENT; CARDIOLOGY; DIALYSIS;
D O I
10.1111/jch.14325
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Hypertension is a frequent manifestation of chronic kidney disease but the ideal blood pressure (BP) target in patients with coronary artery disease (CAD) with end-stage renal disease (ESRD) (eGFR < 15 ml/min/1.73m(2)) still unclear. The authors aimed to investigate the ideal achieved BP in ESRD patients with CAD after coronary intervention. Five hundred and seventy-five ESRD patients who had undergone percutaneous coronary interventions (PCIs) were enrolled and their clinical outcomes were analyzed according to the category of systolic BP (SBP) and diastolic BP (DBP) achieved. The clinical outcomes included major cardiovascular events (MACE) and MACE plus hospitalization for congestive heart failure (total cardiovascular (CV) event).The mean systolic BP was 135.0 +/- 24.7 mm Hg and the mean diastolic BP was 70.7 +/- 13.1 mm Hg. Systolic BP 140-149 mm Hg and diastolic BP 80-89 mm Hg had the lowest MACE (11.0%; 13.2%) and total CV event (23.3%; 21.1%). Patients with systolic BP < 120 mm Hg had a higher risk of MACE (HR: 2.01; 95% CI: 1.17-3.46, p = .008) than those with systolic BP 140-149 mm Hg. Patients with systolic BP >= 160 mm Hg (HR: 1.84; 95% CI, 3.27-1.04, p = .04) and diastolic blood BP >= 90 mm Hg (HR: 2.19; 95% CI: 1.15-4.16, p = .02) had a higher risk of total CV event rate when compared to those with systolic BP 140-149 mm Hg and diastolic BP 80-89 mm Hg. A J-shaped association between systolic (140-149 mm Hg) and diastolic (80-89 mm Hg) BP and decreased cardiovascular events for CAD was found in patients with ESRD after undergoing PCI in non-Western population.
引用
收藏
页码:1622 / 1630
页数:9
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