History of telemetric automatic long-term blood pressure recording

1990 ◽  
pp. 95-110
Author(s):  
B. Krönig
Keyword(s):  
Blood Pressure ◽  
Pressure Recording ◽  
History Of ◽  
Blood Pressure Recording

Long-term systolic blood pressure and all-cause mortality in heart failure with preserved ejection fraction: an analysis of the TOPCAT trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Huang ◽  
C Liu
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Ejection Fraction ◽  
Funding Source ◽  
Preserved Ejection Fraction ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
History Of

Abstract Background Lower systolic blood pressure (SBP) at admission or discharge was associated with poor outcomes in patients with heart failure and preserved ejection fraction (HFpEF). However, the optimal long-term SBP for HFpEF was less clear. Purpose To examine the association of long-term SBP and all-cause mortality among patients with HFpEF. Methods We analyzed participants from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study. Participants had at least two SBP measurements of different times during the follow-up were included. Long-term SBP was defined as the average of all SBP measurements during the follow-up. We stratified participants into four groups according to long-term SBP: <120mmHg, ≥120mmHg and <130mmHg, ≥130mmHg and <140mmHg, ≥140mmHg. Multivariable adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality associated with SBP level. To assess for nonlinearity, we fitted restricted cubic spline models of long-term SBP. Sensitivity analyses were conducted by confining participants with history of hypertension or those with left ventricular ejection fraction≥50%. Results The 3338 participants had a mean (SD) age of 68.5 (9.6) years; 51.4% were women, and 89.3% were White. The median long-term SBP was 127.3 mmHg (IQR 121–134.2, range 77–180.7). Patients in the SBP of <120mmHg group were older age, less often female, less often current smoker, had higher estimated glomerular filtration rate, less often had history of hypertension, and more often had chronic obstructive pulmonary disease and atrial fibrillation. After multivariable adjustment, long-term SBP of 120–130mmHg and 130–140mmHg was associated with a lower risk of mortality during a mean follow-up of 3.3 years (HR 0.65, 95% CI: 0.49–0.85, P=0.001; HR 0.66, 95% CI 0.50–0.88, P=0.004, respectively); long-term SBP of <120mmHg had similar risk of mortality (HR 1.03, 95% CI: 0.78–1.36, P=0.836), compared with long-term SBP of ≥140mmHg. Findings from restricted cubic spline analysis demonstrate that there was J-shaped association between long-term SBP and all-cause mortality (P=0.02). These association was essentially unchanged in sensitivity analysis. Conclusions Among patients with HFpEF, long-term SBP showed a J-shaped pattern with all-cause mortality and a range of 120–140 mmHg was significantly associated with better outcomes. Future randomized controlled trials need to evaluate optimal long-term SBP goal in patients with HFpEF. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): China Postdoctoral Science Foundation Grant (2019M660229 and 2019TQ0380)

Ambulatory blood pressure recording to identify hypertensive patients who truly need therapy

1984 ◽  
Vol 37 (1) ◽  
pp. 55-57 ◽  
Author(s):  
B. Waeber ◽  
B.Jacot Des Combes ◽  
M. Porchet ◽  
J. Biollaz ◽  
M.-D. Schaller ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Hypertensive Patients ◽  
Pressure Recording ◽  
Blood Pressure Recording

Abstract P355: Predicting the 20-year Risk of First Coronary or Ischemic Stroke Event in Northern Italy: The CAMUNI Absolute Risk Equation

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Giovanni Veronesi ◽  
Lloyd E Chambless ◽  
Francesco Gianfagna ◽  
Giuseppe Mancia ◽  
Giancarlo Cesana ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Events ◽  
Absolute Risk ◽  
Northern Italy ◽  
Men And Women ◽  
Basic Model ◽  
History Of

Aims. Recent US guidelines advocate the introduction of lifetime or long-term absolute risk prediction for primary prevention of cardiovascular events, especially for young people and women. Therefore, long-term prediction models might be specially beneficial in population considered at low incidence. We aim to develop a 20-year absolute risk prediction equation in a Northern Italy population. Methods. Four independent population-based cohorts were enrolled between 1986 and 1994 from the Brianza population (Northern Italy), adopting standardized MONICA procedures. The study sample comprises n=2574 men and 2673 women, aged 35 to 69 years and free of CVD at baseline. Participants were followed-up for incidence of first coronary and ischemic stroke events (fatal and non-fatal; all MONICA validated) for a median time of 15 years (IQ range: 12-20) and up to the end of 2008. We compared several gender-specific Cox Proportional Hazards models: the basic one includes age, total cholesterol, HDL-cholesterol, systolic blood pressure, anti-hypertensive treatment, cigarette smoking and diabetes. Candidates to model addition were diastolic blood pressure, triglycerides, BMI, family history of CHD, and education. Model calibration was tested using the Grønnesby-Bogan goodness-of-fit statistic. The Area Under the ROC-Curve (AUC) was a measure of discrimination, corrected for over-optimism via bootstrapping. Changes in discrimination (Δ-AUC) and reclassification (Net Reclassification Improvement, NRI) defined the improvement from the basic model due to an additional risk factor. Intermediate risk was defined as 20-year risk between 10% and 40%. Results. We observed n=286 events in men (incidence rate 7.7 per 1000 person-years) and n=108 in women (2.6 per 1000 person-years). All risk factors included in the basic model were predictive of first cardiovascular event in both genders; discrimination was 0.725 and 0.802 in men and women, respectively. Average specificity in the top risk quintile (cut-off value: 23% in men and 8.5% in women) was similar in men and women (85% vs. 83%), while sensitivity was higher in women (63% vs. 46%). All the models were well-calibrated (p-values >0.05). The addition of a positive family history of CHD in men (Hazard Ratio: 1.6; 95%CI 1.2-2.1) and of diastolic blood pressure in women (HR: 1.4 for 11 mmHg increase; 1.1-1.8) significantly improved discrimination (Δ-AUC=0.01; 95%CI 0.002-0.02 [men] and Δ-AUC=0.005; 95%CI 0.0001-0.01 [women]) and reclassification of subjects at intermediate risk (NRI=8.4%;1.7%-19.1% [men]; and NRI=11.7%; -3.2%-33.5% [women]). Conclusions. Traditional risk factors are predictive of cardiovascular events after 20 years, with good discrimination. The addition of family history of CHD may contribute to model improvement, at least among men; the role of diastolic blood pressure in women should be carefully evaluated.

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