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The 24-hour pulse wave velocity, aortic augmentation index, and central blood pressure in normotensive volunteers.

https://arctichealth.org/en/permalink/ahliterature104335
Source
Vasc Health Risk Manag. 2014;10:247-51
Publication Type
Article
Date
2014
Author
Tatyana Y Kuznetsova
Viktoria A Korneva
Evgeniya N Bryantseva
Vitaliy S Barkan
Artemy V Orlov
Igor N Posokhov
Anatoly N Rogoza
Author Affiliation
Faculty of Medicine, Petrozavodsk State University, Petrozavodsk, Russia.
Source
Vasc Health Risk Manag. 2014;10:247-51
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Algorithms
Blood pressure
Blood Pressure Monitoring, Ambulatory - standards
Circadian Rhythm
Diastole
Female
Healthy Volunteers
Heart rate
Humans
Male
Middle Aged
Predictive value of tests
Pulse Wave Analysis - standards
Reference Values
Russia
Signal Processing, Computer-Assisted
Systole
Time Factors
Vascular Stiffness
Abstract
The purpose of this study was to examine the pulse wave velocity, aortic augmentation index corrected for heart rate 75 (AIx@75), and central systolic and diastolic blood pressure during 24-hour monitoring in normotensive volunteers. Overall, 467 subjects (206 men and 261 women) were recruited in this study. Participants were excluded from the study if they were less than 19 years of age, had blood test abnormalities, had a body mass index greater than 2 7.5 kg/m(2), had impaired glucose tolerance, or had hypotension or hypertension. Ambulatory blood pressure monitoring (ABPM) with the BPLab(®) device was performed in each subject. ABPM waveforms were analyzed using the special automatic Vasotens(®) algorithm, which allows the calculation of pulse wave velocity, AIx@75, central systolic and diastolic blood pressure for "24-hour", "awake", and "asleep" periods. Circadian rhythms and sex differences in these indexes were identified. Pending further validation in prospective outcome-based studies, our data may be used as preliminary diagnostic values for the BPLab ABPM additional index in adult subjects.
Notes
Cites: J Invasive Cardiol. 2009 Jun;21(6):270-719494403
Cites: Hypertens Res. 2012 Oct;35(10):980-722622282
Cites: Am J Hypertens. 2010 Feb;23(2):180-519959999
Cites: J Hypertens. 2013 Jul;31(7):1281-35723817082
Cites: Vasc Health Risk Manag. 2011;7:649-5622140314
Cites: Age (Dordr). 2013 Dec;35(6):2345-5523319362
Cites: Hypertension. 2013 Jun;61(6):1148-923630945
Cites: Hypertension. 2013 Jun;61(6):1168-7623630950
Cites: J Hypertens. 2013 Sep;31(9):1731-6824029863
Cites: Eur Heart J. 2010 Oct;31(19):2338-5020530030
PubMed ID
24812515 View in PubMed
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ACE inhibitors captopril and enalapril induce regression of left ventricular hypertrophy in hypertensive patients with chronic renal failure.

https://arctichealth.org/en/permalink/ahliterature54522
Source
Nephrol Dial Transplant. 1997 May;12(5):945-51
Publication Type
Article
Date
May-1997
Author
A I Dyadyk
A E Bagriy
I A Lebed
N F Yarovaya
E V Schukina
G G Taradin
Author Affiliation
Department of Postgraduate Therapy Training, Medical University, Donetsk, Ukraine.
Source
Nephrol Dial Transplant. 1997 May;12(5):945-51
Date
May-1997
Language
English
Publication Type
Article
Keywords
Adult
Angiotensin-Converting Enzyme Inhibitors - adverse effects - therapeutic use
Blood Pressure - drug effects
Captopril - adverse effects - therapeutic use
Diastole - drug effects
Drug Tolerance
Enalapril - adverse effects - therapeutic use
Female
Hemodynamic Processes - drug effects
Humans
Hypertension - complications - drug therapy - physiopathology
Hypertrophy, Left Ventricular - complications - drug therapy - pathology
Kidney Failure, Chronic - complications
Male
Middle Aged
Prospective Studies
Single-Blind Method
Systole - drug effects
Ventricular Function, Left - drug effects
Abstract
BACKGROUND: Left ventricular hypertrophy is frequently noted in patients with moderate to severe chronic renal failure not requiring dialysis. Recently, several studies have shown reversal of myocardial hypertrophy in end-stage renal disease with long-term pharmacological control of blood pressure, but it is unclear whether left ventricular mass regresses or normalizes with antihypertensive treatment of patients with earlier stages of chronic renal failure. METHODS: Seventy-two undialysed patients with chronic renal failure, chronic mild-to-moderate hypertension, and left ventricular hypertrophy were randomly assigned in a prospective study to either the captopril (n = 36) or enalapril group (n = 36). Blood pressure measurements, echocardiographic and Doppler parameters were evaluated before treatment and at 6 and 12 months of therapy. RESULTS: During follow-up, six patients developed side-effects including dry cough, taste disturbances, skin rash and gastric intolerance. In the captopril group there was a decrease in mean left ventricular mass index by 12% after 6 months of treatment, which decreased by 20% after 12 months treatment. For enalapril, the average reduction of myocardial mass after 6 months treatment was 14% and after 12 months treatment, the decrease was 19%. In both treatment groups there was significant improvement of left ventricular filling dynamics. No deterioration of left ventricular systolic function was observed. CONCLUSIONS: Our results confirm that antihypertensive monotherapy with the ACE inhibitors, captopril and enalapril, in patients with chronic renal failure results in regression of left ventricular mass index associated with a significant improvement in the diastolic function of the left ventricle without a demonstrable deterioration in left ventricular systolic performance.
PubMed ID
9175047 View in PubMed
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Acute effects on the ventricular function in Swedish snuffers: an echocardiographic study.

https://arctichealth.org/en/permalink/ahliterature127427
Source
Clin Physiol Funct Imaging. 2012 Mar;32(2):106-13
Publication Type
Article
Date
Mar-2012
Author
D. Sundström
M. Waldenborg
K. Emilsson
Author Affiliation
Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden. daniel.sundstrom@orebroll.se
Source
Clin Physiol Funct Imaging. 2012 Mar;32(2):106-13
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Blood pressure
Diastole
Echocardiography, Doppler
Echocardiography, Doppler, Color
Echocardiography, Doppler, Pulsed
Female
Heart rate
Humans
Male
Middle Aged
Predictive value of tests
Stroke Volume
Sweden
Systole
Time Factors
Tobacco, Smokeless - adverse effects
Ventricular Dysfunction, Left - etiology - physiopathology - ultrasonography
Ventricular Dysfunction, Right - etiology - physiopathology - ultrasonography
Ventricular Function, Left
Ventricular Function, Right
Young Adult
Abstract
Cigarettes and Swedish snuff contain nicotine, which influence the cardiovascular system. Cigarette smoke has been shown to give an acute impairment in diastolic heart parameters. The systolic and diastolic heart function in snuff users is not thoroughly enough investigated. The aim of this study was to investigate if Swedish snuff will give an acute decrease in systolic and diastolic heart parameters in the left and right ventricles in healthy Swedish snuffers.
Thirty healthy volunteers were examined with echocardiography. The study involved recordings from four different times: before snuff intake, 5 and 30 min after intake and finally 30 min after snuff withdrawal. The systolic and diastolic heart parameters were collected with conventional echocardiographic methods. In addition, the heart frequency and blood pressure response were measured. The pulse and blood pressure response were significantly altered (P
PubMed ID
22296630 View in PubMed
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Adaptive or maladaptive response to adenoviral adrenomedullin gene transfer is context-dependent in the heart.

https://arctichealth.org/en/permalink/ahliterature92802
Source
J Gene Med. 2008 Aug;10(8):867-77
Publication Type
Article
Date
Aug-2008
Author
Leskinen Hanna
Rauma-Pinola Tanja
Szokodi István
Kerkelä Risto
Pikkarainen Sampsa
Uusimaa Paavo
Hautala Timo
Vuolteenaho Olli
Ruskoaho Heikki
Author Affiliation
Institute of Biomedicine, Department of Pharmacology and Toxicology, Biocentre Oulu, University of Oulu, Oulu, Finland.
Source
J Gene Med. 2008 Aug;10(8):867-77
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adenoviridae - drug effects
Adrenomedullin - metabolism - pharmacology
Animals
Gene Transfer Techniques
Heart - drug effects - physiology - physiopathology
Heart Ventricles - drug effects
Hypertrophy, Left Ventricular - metabolism - physiopathology
Male
Myocardial Infarction - physiopathology
Myocardium - metabolism
RNA, Messenger - metabolism
Rats
Rats, Sprague-Dawley
Systole - drug effects
Ventricular Function, Left - drug effects
Abstract
BACKGROUND: Adrenomedullin (AM) is a potent vasodilator and natriuretic peptide produced in the heart, but controversy persists regarding its cardiac effects. We explored the potential role of AM on cardiac function and remodeling by direct recombinant adenoviral AM gene delivery into the anterior wall of the left ventricle (LV). METHODS: AM was overexpressed in healthy rat hearts and in hearts during the remodeling process in response to pressure overload and myocardial infarction. The AM effects were analysed with echocardiography and in an isolated perfused rat heart preparation. The expression of AM and the activation of underlying signaling pathways were also investigated. RESULTS: AM mRNA increased by 20.9-fold (p
PubMed ID
18615773 View in PubMed
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AGT M235T and ACE ID polymorphisms and exercise blood pressure in the HERITAGE Family Study.

https://arctichealth.org/en/permalink/ahliterature197889
Source
Am J Physiol Heart Circ Physiol. 2000 Jul;279(1):H368-74
Publication Type
Article
Date
Jul-2000
Author
T. Rankinen
J. Gagnon
L. Pérusse
Y C Chagnon
T. Rice
A S Leon
J S Skinner
J H Wilmore
D C Rao
C. Bouchard
Author Affiliation
Pennington Biomedical Research Center, Human Genomics Laboratory, Baton Rouge, Louisiana 70808, USA.
Source
Am J Physiol Heart Circ Physiol. 2000 Jul;279(1):H368-74
Date
Jul-2000
Language
English
Publication Type
Article
Keywords
Adult
Amino Acid Substitution
Angiotensinogen - genetics
Blood Pressure - genetics - physiology
Canada
Cohort Studies
DNA Transposable Elements
Diastole
European Continental Ancestry Group
Exercise - physiology
Female
Genotype
Humans
Male
Oxygen consumption
Peptidyl-Dipeptidase A - genetics
Physical Exertion - physiology
Polymorphism, Genetic
Sequence Deletion
Sex Characteristics
Systole
United States
Abstract
We investigated the association between angiotensinogen (AGT) and angiotensin-converting enzyme (ACE) gene polymorphisms and exercise training responses of resting and exercise blood pressure (BP). BP at rest and during submaximal (50 watts) and maximal exercise tests was measured before and after 20 wk of endurance training in 476 sedentary normotensive Caucasian subjects from 99 families. AGT M235T and ACE insertion/deletion polymorphisms were typed with PCR-based methods. Men carrying the AGT MM and MT genotypes showed 3. 7 +/- 0.6 and 3.2 +/- 0.5 (SE) mmHg reductions, respectively, in diastolic BP at 50 watts (DBP(50)), whereas, in the TT homozygotes, the decrease was 0.4 +/- 1.0 mmHg (P = 0.016 for trend, adjusted for age, body mass index, and baseline DBP(50)). Men with the ACE DD genotype showed a slightly greater decrease in DBP(50) (4.4 +/- 0.6 mmHg) than the II and ID genotypes (2.8 +/- 0.7 and 2.4 +/- 0.5 mmHg, respectively, P = 0.050). Furthermore, a significant (P = 0.022) interaction effect between the AGT and ACE genes was noted for DBP(50); the AGT TT homozygotes carrying the ACE D allele showed no response to training. Men with the AGT TT genotype had greater (P = 0.007) diastolic BP (DBP) response to acute maximal exercise at baseline. However, the difference disappeared after the training period. No associations were found in women. These data suggest that, in men, the genetic variation in the AGT locus modifies the responsiveness of submaximal exercise DBP to endurance training, and interactions between the AGT and ACE loci can alter this response.
PubMed ID
10899077 View in PubMed
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An echocardiographic evaluation of patients with idiopathic heart failure.

https://arctichealth.org/en/permalink/ahliterature54794
Source
Chest. 1995 Mar;107(3):680-9
Publication Type
Article
Date
Mar-1995
Author
B. Andersson
K. Caidahl
F. Waagstein
Author Affiliation
Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Göteborg University, Sweden.
Source
Chest. 1995 Mar;107(3):680-9
Date
Mar-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cardiomyopathy, Dilated - ultrasonography
Diastole - physiology
Dilatation, Pathologic
Echocardiography
Female
Heart Failure, Congestive - physiopathology - ultrasonography
Humans
Male
Middle Aged
Sensitivity and specificity
Stroke Volume
Systole - physiology
Ventricular Dysfunction, Left - ultrasonography
Abstract
The primary myocardial disease idiopathic dilated cardiomyopathy (IDCM) is not clearly defined in the literature. The description is both morphologic and etiologic. We examined consecutive patients with congestive heart failure (CHF) of unknown cause to identify possible cases of IDCM and to give a detailed description of echocardiographic data and possible diastolic dysfunction in this group. The hospital records of patients aged 16 to 65 years hospitalized due to CHF or IDCM during a 6-year period (N = 2,711) were evaluated in a defined region of western Sweden. Twenty-two percent (584/2,711) of these records contained no plausible cause of CHF or IDCM, and among patients being alive, obvious cause was lacking in 411 of 1,516 (27%). These 411 patients were offered a diagnostic investigation, including echocardiography, and they were compared with a randomly selected control group (n = 103) from the general population. Of 411 patients, 293 accepted investigation. From the control group, we defined the reference level for left ventricular (LV) dilatation to be > 32 mm/m2, and reduced ejection fraction according to Teichholz formula to be
PubMed ID
7874937 View in PubMed
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The angiotensin receptor blocker eprosartan mesylate reduces pulse pressure in isolated systolic hypertension.

https://arctichealth.org/en/permalink/ahliterature168579
Source
Can J Cardiol. 2004 Oct;20 Suppl C:11C-16C
Publication Type
Article
Date
Oct-2004
Author
Ivor Teitelbaum
Martyn Chilvers
Ruby J Shanlin Reiz
Author Affiliation
Yorkview Medical Centre, Downsview, Canada.
Source
Can J Cardiol. 2004 Oct;20 Suppl C:11C-16C
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Acrylates - administration & dosage - adverse effects
Administration, Oral
Age Factors
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - administration & dosage - adverse effects
Blood Pressure - drug effects
Blood Pressure Determination
Canada
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Hypertension - diagnosis - drug therapy
Imidazoles - administration & dosage - adverse effects
Male
Middle Aged
Probability
Reference Values
Severity of Illness Index
Systole - drug effects
Thiophenes - administration & dosage - adverse effects
Treatment Outcome
Abstract
Isolated systolic hypertension (ISH) is a common and particularly poorly controlled form of hypertension.
To assess the effect of eprosartan 600 mg tablet once daily on blood pressure (BP), pulse pressure, BP response, compliance and safety in subjects with ISH compared with subjects with combined systolic-diastolic hypertension (non-ISH).
The present study is a post hoc evaluation of a prospective, randomized, open-label, multicentre study. Subjects 60 to 84 years old with ISH (systolic BP 140 mmHg or greater with diastolic BP less than 90 mmHg) (n=97) or non-ISH (systolic BP 140 mmHg or greater with diastolic BP 90 mmHg or greater) (n=98) received 10 weeks of treatment with either eprosartan alone or eprosartan plus home BP monitoring.
Eprosartan significantly reduced systolic BP at the study end point from baseline in both the ISH group and the non-ISH group (-17.5+/-14.5 mmHg and -20.6+/-14.1 mmHg [mean +/- SD], respectively; P
PubMed ID
16807618 View in PubMed
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Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy.

https://arctichealth.org/en/permalink/ahliterature53541
Source
J Hum Hypertens. 2003 May;17(5):305-11
Publication Type
Article
Date
May-2003
Author
M H Olsen
E. Hjerkinn
K. Wachtell
A. Høieggen
J N Bella
S D Nesbitt
E. Fossum
S E Kjeldsen
S. Julius
H. Ibsen
Author Affiliation
Department of Clinical Physiology and Nuclear Medicine, Glostrup University Hospital, Copenhagen, Denmark. mho@dadlnet.dk
Source
J Hum Hypertens. 2003 May;17(5):305-11
Date
May-2003
Language
English
Publication Type
Article
Keywords
Aged
Blood Flow Velocity - physiology
Blood Glucose - metabolism
Blood Pressure - physiology
Carotid Artery, Common - physiopathology
Comparative Study
Denmark
Diastole - physiology
Echocardiography
Female
Heart Ventricles - metabolism - physiopathology - ultrasonography
Humans
Hypertension - metabolism - physiopathology
Hypertrophy, Left Ventricular - metabolism - physiopathology
Insulin - blood
Insulin Resistance - physiology
Male
Middle Aged
Norway
Research Support, Non-U.S. Gov't
Sex Factors
Statistics
Stroke Volume - physiology
Systole - physiology
United States
Vascular Resistance - physiology
Ventricular Function, Left - physiology
Ventricular Remodeling - physiology
Abstract
Vascular hypertrophy and insulin resistance have been associated with abnormal left ventricular (LV) geometry in population studies. We wanted to investigate the influence of vascular hypertrophy and insulin resistance on LV hypertrophy and its function in patients with hypertension. In 89 patients with essential hypertension and electrocardiographic LV hypertrophy, we measured blood pressure; insulin sensitivity by hyperinsulinaemic euglucaemic clamp; minimal forearm vascular resistance (MFVR) by plethysmography; intima-media cross-sectional area of the common carotid arteries (IMA) by ultrasound; and LV mass, relative wall thickness (RWT), systolic function and diastolic filling by echocardiography after two weeks of placebo treatment. LV mass index correlated to IMA/height (r=0.36, P=0.001), serum insulin (r=-0.25, P
Notes
Comment In: J Hum Hypertens. 2003 May;17(5):299-30412756401
PubMed ID
12756402 View in PubMed
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Arterial baroreflex impairment in patients during acute coronary occlusion.

https://arctichealth.org/en/permalink/ahliterature10780
Source
J Am Coll Cardiol. 1998 Nov 15;32(6):1641-7
Publication Type
Article
Date
Nov-15-1998
Author
K E Airaksinen
K U Tahvanainen
D L Eckberg
M J Niemelä
A. Ylitalo
H V Huikuri
Author Affiliation
Department of Medicine, University of Oulu, Finland. kari.airaksinen@oulu.fi
Source
J Am Coll Cardiol. 1998 Nov 15;32(6):1641-7
Date
Nov-15-1998
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Arteries - physiopathology
Balloon Dilatation
Baroreflex - physiology
Blood Pressure - drug effects - physiology
Coronary Disease - diagnosis - physiopathology - therapy
Coronary Vessels - physiopathology
Female
Heart Rate - physiology
Humans
Male
Middle Aged
Phenylephrine - diagnostic use
Research Support, Non-U.S. Gov't
Systole
Vasoconstrictor Agents - diagnostic use
Abstract
OBJECTIVES: We tested whether acute coronary occlusion interferes with arterial baroreceptor control of heart rate in humans. BACKGROUND: Subnormal baroreflex sensitivity (BRS) is an important risk indicator for sudden death. Animal research indicates that both chronic myocardial infarction and acute coronary occlusion impair baroreflex modulation of heart rate. METHODS: We measured RR interval prolongation after phenylephrine-induced systolic pressure increases before and during 2-min coronary occlusions in 47 patients (27 men) undergoing clinically indicated single-vessel coronary angioplasty for stenoses in the proximal or midportion of the vessel causing >50% reduction in the arterial diameter, with normal antegrade flow (33 anterior descending, 10 circumflex, 4 right coronary artery). A control group of 11 patients treated for chronic total occlusion of a coronary artery was assessed to evaluate nonspecific changes in baroreflex function during a 2-min balloon inflation in the occluded artery. RESULTS: The BRS decreased from 5.2+/-3.8 (mean+/-SD) to 4.1+/-3.5 ms x mm Hg(-1) (p=0.01) during the coronary occlusion in the 28 patients with preserved arterial baroreceptor control of heart rate-that is, adequate blood pressure responses and correlation coefficients of the slopes both in baseline and during coronary occlusion. The same phenylephrine dose increased systolic pressure less during than before coronary artery occlusion (21+/-21 versus 36+/-16 mm Hg, p
PubMed ID
9822091 View in PubMed
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Association between admission supine systolic blood pressure and 1-year mortality in patients admitted to the intensive care unit for acute chest pain.

https://arctichealth.org/en/permalink/ahliterature97600
Source
JAMA. 2010 Mar 24;303(12):1167-72
Publication Type
Article
Date
Mar-24-2010
Author
Ulf Stenestrand
Magnus Wijkman
Mats Fredrikson
Fredrik H Nystrom
Author Affiliation
Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden.
Source
JAMA. 2010 Mar 24;303(12):1167-72
Date
Mar-24-2010
Language
English
Geographic Location
Sweden
Publication Type
Article
Keywords
Acute Disease
Aged
Aged, 80 and over
Blood pressure
Chest Pain
Female
Follow-Up Studies
Humans
Hypertension - complications - mortality
Intensive Care Units
Male
Middle Aged
Mortality - trends
Myocardial Ischemia - mortality
Patient Admission
Prognosis
Prospective Studies
Registries - statistics & numerical data
Risk
Supine Position
Sweden - epidemiology
Systole
Abstract
CONTEXT: High resting blood pressure (BP) is among the best studied and established risk factors for cardiovascular disease. However, little is known about the relationship between BP under acute stress, such as in acute chest pain, and subsequent mortality. OBJECTIVE: To study long-term mortality related to supine BP in patients admitted to the medical intensive care unit (ICU) for acute chest pain. DESIGN, SETTING, AND PARTICIPANTS: Data from the RIKS-HIA (Registry of Information and Knowledge About Swedish Heart Intensive Care Admissions) was used to analyze the mortality in relation to supine admission systolic BP in 119,151 participants who were treated at the ICU for the symptom of chest pain from 1997 through 2007. Results from this prospective cohort study were presented according to systolic BP quartiles: Q1, less than 128 mm Hg; Q2, from 128 to 144 mm Hg; Q3, from 145 to 162 mm Hg; and Q4, at or above 163 mm Hg. MAIN OUTCOME MEASURE: Total mortality. RESULTS: Mean (SD) follow-up time was 2.47 (1.5) years (range, 1-10 years). One-year mortality rate by Cox proportional hazard model (adjusted for age, sex, smoking, diastolic BP, use of antihypertensive medication at admission and discharge, and use of lipid-lowering and antiplatelet medication at discharge) showed that participants in Q4 had the best prognosis (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.72-0.80, Q4 compared with Q2; corresponding risks for Q1 were HR, 1.46; 95% CI, 1.39-1.52, and for Q3, HR, 0.83; 95% CI, 0.79-0.87). Patients in Q4 had a 21.7% lower absolute risk compared with Q2, patients in Q3 had a 15.2% lower risk than in Q2, and patients in Q1 had a 40.3% higher risk for mortality than in Q2. The worse prognosis in Q2 compared with Q4 was independent of body mass index and previous diagnoses and similar when analysis was restricted to patients with a final diagnosis of angina or myocardial infarction (HR, 0.75; 95% CI, 0.71-0.80, Q4 compared with Q2). CONCLUSION: Among patients admitted to the ICU for chest pain, there is an inverse association between admission supine systolic BP and 1-year mortality rate.
Notes
RefSource: JAMA. 2010 Jul 7;304(1):40; author reply 40-1
PubMed ID
20332402 View in PubMed
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238 records – page 1 of 24.