Abstract WP212: Association Between Within-visit Blood Pressure Variability and Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Michelle P Lin ◽  
Bruce Ovbiagele ◽  
Rebecca F Gottesman ◽  
Nerses Sanossian ◽  
Daniela Markovic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mexican American ◽  
Blood Pressure Variability ◽  
Peripheral Artery ◽  
Factors Associated ◽  
Health And Nutrition ◽  
The Us ◽  
Artery Disease ◽  
The Relationship

Introduction: Long-term variability in systolic blood pressure (SBP) is associated with higher risk of cardiovascular events. Little is known about the association between within-visit SBP variability and stroke. Hypothesis: Higher within-visit SBP variability is associated with higher odds of stroke. Methods: Participants included adults ≥18 years who participated in the US National Health and Nutrition Examination Surveys from 1999 to 2010. Stroke was self-reported. SBP was obtained up to four times by a physician, using a manual sphygmomanometer according standardized procedures. Within-visit SBP variability was defined as standard deviation of the BP measurements, stratified into quartiles. We evaluated the relationship between within-visit SBP variability and odds of having had a stroke using multivariable logistic regression. Results: Of the 27,987 adults, 16.4% were aged ≥ 65 years, 51.3% were female, 71.2% were White, 10.7% were Black and 7.9% were Mexican American. Factors associated with higher mean SBP variability included older age, hypertension, chronic kidney disease, peripheral artery disease, and smoking (all P<0.05). The prevalence of stroke significantly increased across SBP variability quartiles from 2.1% for quartile 1 to 3.7% for quartile 4. High SBP variability was associated with higher odds of stroke (OR 1.8, 95% CI 1.4-2.2). After adjustment for covariates, the odds ratio of stroke comparing highest vs. lowest quartile of SBP variability was 0.9 (p=0.400). Conclusions: Within-visit variability in SBP is associated with increased odds of stroke but the relationship is confounded by age and covariates.

scholarly journals Association of 1-Year Blood Pressure Variability With Long-term Mortality Among Adults With Coronary Artery Disease

2021 ◽  
Vol 4 (4) ◽  
pp. e218418
Author(s):  
Osama Dasa ◽  
Steven M. Smith ◽  
George Howard ◽  
Rhonda M. Cooper-DeHoff ◽  
Yan Gong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Blood Pressure Variability ◽  
Artery Disease ◽  
Long Term Mortality

scholarly journals Shorter Leukocyte Telomere Length in Relation to Presumed Nonalcoholic Fatty Liver Disease in Mexican-American Men in NHANES 1999–2002

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Janet M. Wojcicki ◽  
David Rehkopf ◽  
Elissa Epel ◽  
Philip Rosenthal
Keyword(s):  
Telomere Length ◽  
Abdominal Obesity ◽  
Mexican American ◽  
Elevated Serum ◽  
Leukocyte Telomere Length ◽  
Nonalcoholic Fatty Liver ◽  
Logistic Regression Models ◽  
Health And Nutrition ◽  
Artery Disease ◽  
The Relationship

Leukocyte telomere length is shorter in response to chronic disease processes associated with inflammation such as diabetes mellitus and coronary artery disease. Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2002 was used to explore the relationship between leukocyte telomere length and presumed NAFLD, as indicated by elevated serum alanine aminotransferase (ALT) levels, obesity, or abdominal obesity. Logistic regression models were used to evaluate the relationship between telomere length and presumed markers of NAFLD adjusting for possible confounders. There was no relationship between elevated ALT levels, abdominal obesity, or obesity and telomere length in adjusted models in NHANES (OR 1.13, 95% CI 0.48–2.65; OR 1.17, 95% CI 0.52–2.62, resp.). Mexican-American men had shorter telomere length in relation to presumed NAFLD (OR 0.07, 95% CI 0.006–0.79) and using different indicators of NAFLD (OR 0.012, 95% CI 0.0006–0.24). Mexican origin with presumed NAFLD had shorter telomere length than men in other population groups. Longitudinal studies are necessary to evaluate the role of telomere length as a potential predictor to assess pathogenesis of NALFD in Mexicans.

Endovascular treatment of peripheral artery disease reduces blood pressure and improves long-term prognosis

2015 ◽  
Vol 186 ◽  
pp. 161-163 ◽  
Author(s):  
Toshihiro Nozato ◽  
Akira Sato ◽  
Tetsuo Oumi ◽  
Shunsuke Hirose ◽  
Ryuichi Kato ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endovascular Treatment ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Long Term Prognosis

Abstract 177: Heterogeneity in Blood Pressure Management in Patients With Peripheral Artery Disease; Insights From the PORTRAIT Registry

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Poghni A Peri-Okonny ◽  
Krishna Patel ◽  
Jingyan Wang ◽  
Nancy Stone ◽  
Kim Smolderen
Keyword(s):  
Blood Pressure ◽  
Peripheral Artery Disease ◽  
Beta Blockers ◽  
Performance Measure ◽  
Prior History ◽  
Significant Heterogeneity ◽  
Peripheral Artery ◽  
The Us ◽  
Artery Disease ◽  
New Guidelines

Introduction: Patients with peripheral artery disease (PAD) are known to have the highest cardiovascular risk across the spectrum of patients with atherothrombotic disease. Hypertension (HTN) management is currently not a key performance measure for PAD despite being a common risk factor in patients with PAD. As there is lack of data on the management of blood pressure (BP) in PAD, we prospectively studied BP management among patients with new or worsening symptomatic PAD. Methods: In PORTRAIT, patients were evaluated for new or worsening PAD symptoms in 16 PAD clinics across the US, Netherlands and Australia. BP was measured in clinic and at time of enrollment. HTN was defined as prior history of HTN, use of antihypertensives or [SBP ≥140 or DBP ≥90 mmHg per old guidelines; or SBP≥130 or DBP≥80 per new ACC/AHA guidelines]. Untreated HTN was defined as patients with HTN who were not on antihypertensive therapy. HTN with BP <140/90 (old) or <130/80 (new guidelines) was defined as controlled HTN. We estimated country differences in BP and untreated HTN rates. Median odds ratio (MOR) and 95% confidence intervals was derived from hierarchical logistic regression modelling to estimate variability in achieving controlled HTN. Results: Among 1006 participants with documented BP, the prevalence of HTN increased from 96% to 98% based on old and new definitions respectively. BP control decreased from 51% (old) to 31% (new definition). Beta blockers (66.1%) were the most commonly used antihypertensive drug class (Table 1). Overall, 6.5% and 8.3% of HTN patients were untreated based on the old and new definitions respectively. Mean BP was lowest in the US compared to Netherlands and Australia (135/73 ± 21/11 mmHg, 146/76 ± 22/12, 151/80 ± 19/10, p <0.001) respectively. The MOR across sites was 1.7 (1.3 -2.5) for BP <140/90 (p <0.001), and 1.4 (1.0 -2.1) for BP<130/80 (p = 0.045) after adjusting for country. Conclusion: The prevalence of HTN among PAD patients with new or worsening symptoms was high independent of BP cut off. Based on new HTN definition, only 1 in 3 HTN patients in this cohort have controlled BP. There was significant heterogeneity in BP control and rates of untreated hypertension differed by country independent of HTN definition. This suggests an opportunity to improve BP control in PAD patients.

scholarly journals Association between Triglyceride Glucose Index and the Risk of Peripheral Artery Disease

2021 ◽  
Author(s):  
Yihai Liu ◽  
Mingyue Wu ◽  
Biao Xu ◽  
Lina Kang
Keyword(s):  
Peripheral Artery Disease ◽  
Surrogate Marker ◽  
Vascular Diseases ◽  
Peripheral Artery ◽  
Tyg Index ◽  
Health And Nutrition ◽  
Triglyceride Glucose Index ◽  
Artery Disease ◽  
The Relationship ◽  
Cardiometabolic Factors

Abstract Background The triglyceride glucose (TyG) index has been used as a simple surrogate marker of insulin resistance, an independent predictor of atherosclerotic vascular diseases. However, few studies have investigated the relationship between the TyG index and peripheral artery disease (PAD).Methods A total of 3375 participants with comleted TyG and ankle brachial pressure index (ABPI) records were enrolled from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. The TyG index was calculated as ln[triglycerides (mg/dL)×glucose (mg/dL)/2], and the presence of PAD was defined as ABPI ≤ 0.9. Results The participants were 60.1±12.8 year old and 51.3% (1730) were male. The prevelance of PAD was 7.1% (238). Compared with the reference lowest quartile of TyG index, the highest quartile was associated with 1.66-fold (odds ratio [OR], 95% confidence interval [CI] 1.15-2.43; p=0.008) risk of PAD. After adjusted for sociodemographic, lifestyles, and cardiometabolic factors, the multivariate-adjusted OR and 95% CI were 1.55 (1.03-2.37; p=0.039) or participants within the highest quartile. TyG index was also independently and linearly associated with higher presence of PAD (OR 1.27 [1.02-1.56]; p=0.027). Subgroup analysis showed that the association between TyG index and the risk of PAD was still consistant across groups except for obesity.Conclusions Higher TyG index was significantly associated with the higher risk of PAD, which could be a marker of PAD.

scholarly journals The Relationship between Intradialytic Hypotension and Hospitalized Mesenteric Ischemia

2018 ◽  
Vol 13 (10) ◽  
pp. 1517-1525 ◽  
Author(s):  
Eun Young Seong ◽  
Yuanchao Zheng ◽  
Wolfgang C. Winkelmayer ◽  
Maria E. Montez-Rath ◽  
Tara I. Chang
Keyword(s):  
Mesenteric Ischemia ◽  
Intradialytic Hypotension ◽  
Intestinal Metabolism ◽  
Peripheral Artery ◽  
Black Race ◽  
High Prevalence ◽  
The Us ◽  
Direct Association ◽  
Artery Disease ◽  
The Relationship

Background and objectivesMesenteric ischemia is a rare but devastating condition caused by insufficient blood supply to meet the demands of intestinal metabolism. In patients with ESKD, it can be difficult to diagnose and has a >70% mortality rate. Patients on hemodialysis have a high prevalence of predisposing conditions for mesenteric ischemia, but the contribution of intradialytic hypotension, a potential modifiable risk factor, has not been well described.Design, setting, participants, & measurementsWe used data from the US Renal Data System to identify 626 patients on hemodialysis with a hospitalized mesenteric ischemia event (cases). We selected 2428 controls in up to a 1:4 ratio matched by age, sex, black race, incident dialysis year, diabetes mellitus, coronary artery disease, and peripheral artery disease. We used six different definitions of intradialytic hypotension on the basis of prior studies, and categorized patients as having had intradialytic hypotension if ≥30% of hemodialysis sessions in the 30 days before the event met the specified definition.ResultsThe proportion of patients with intradialytic hypotension varied depending on its definition: from 19% to 92% of cases and 11% to 94% of controls. Cases had a higher adjusted odds (1.82; 95% confidence interval, 1.47 to 2.26) of having had intradialytic hypotension in the preceding 30 days than controls when using nadir-based intradialytic hypotension definitions such as nadir systolic BP <90 mm Hg. To examine a potential dose-response association of intradialytic hypotension with hospitalized mesenteric ischemia, we categorized patients by the proportion of hemodialysis sessions having intradialytic hypotension, defined using the Nadir90 definition (0%, 1%–9%, 10%–29%, 30%–49%, and ≥50%), and found a direct association of proportion of intradialytic hypotension with hospitalized mesenteric ischemia (P-trend<0.001).ConclusionsPatients with hospitalized mesenteric ischemia had significantly higher odds of having had intradialytic hypotension in the preceding 30 days than controls, as defined by nadir-based definitions.

Abstract P175: Predictors of Long Term Blood Pressure Variability in Young Adulthood Through Middle Age: The Coronary Artery Risk Development in Young Adults Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yacob Tedla ◽  
Yuichiro Yano ◽  
Mercedes Carnethon ◽  
Philip Greenland ◽  
Donald Lloyd-Jones
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Linear Regression ◽  
Total Cholesterol ◽  
Blood Pressure Variability ◽  
Alcohol Intake ◽  
Density Lipoprotein ◽  
White Race ◽  
Factors Associated

Introduction: Long-term blood pressure variability (BPV) refers to fluctuation in BP that occur over weeks, months and years. BPV has been identified as a risk factor for the development of subclinical and clinical cardiovascular events independent of mean BP. However, little is known about the factors associated with long-term BPV. We hypothesized that long-term BPV will vary by demographic, behavioral, anthropometric, lab, and clinical factors. Methods: Using data from the CARDIA study – a longitudinal population based cohort study, we investigated whether baseline demographics (age, sex, race, education); behavioral factors (smoking, alcohol intake, physical activity); anthropometric measures (height, weight, body mass index - BMI); lab markers (total cholesterol, high density lipoprotein cholesterol - HDL-C, low density lipoprotein cholesterol – LDL-C, triglycerides, fasting blood glucose, glomerular filtration rate - GFR); and history of asthma are associated with different indictors of long-term BPV. Variability independent of the mean (VIM) and coefficient of variation (CV) of BP were calculated to quantify within-individual long-term BPV from baseline to visit 9 across 30 years. A least absolute shrinkage and selection operator (lasso) linear regression was used to identify variables that may be associated with long-term BPV and multivariate linear regression models were used to assess magnitude of association. Results: Participants were 3,095 individuals who were not taking antihypertensive medication (mean age 24.6 years, 45.5% male and 56.9% white). Mean VIM was 8.5 mmHg (SD=3.7) for systolic and 7.1 mmHg (SD=3.2) for diastolic BP. Age, sex, race, education, physical activity, alcohol intake, pack-years of smoking, height, weight, triglyceride, LDL-C and asthma were potential correlates of VIM or CV of diastolic BP by the lasso model. In addition to those variables, total cholesterol, HDL-C, fasting glucose, and GFR were potential correlates of VIM or CV of systolic BP. Variables that significantly associated with VIM of systolic BP were: age (years) (β=0.11, p<0.001), white race (β= -0.94, p<0.001), female sex (β=1.36, p<0.001), alcohol intake (drinks/wk) (β=0.01, p=0.001), height (cm) (β= -0.03, p=0.001), and history asthma (β=-0.47, p=0.02). Consistent findings were observed when the outcome was CV of systolic BP. VIM of diastolic BP was also significantly associated with age (β= -0.09, p<0.001) white race (β= -0.47, p=0.26), pack-years (β=0.06, p<0.001), height (cm) (β= -0.03, p<0.001), and history asthma (β=-0.47, p=0.01). The same variables were significantly associated with CV of diastolic BP. Conclusion: Identifying factors associated with long-term BPV can be useful to detect individuals who may be at a greater risk for future higher long-term BPV, which in turn is associated with greater cardiovascular risk.

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