Conference Paper: Visit-to-visit systolic blood pressure variability predicts all-cause and cardiovascular mortality after lacunar infarct

TitleVisit-to-visit systolic blood pressure variability predicts all-cause and cardiovascular mortality after lacunar infarct
Authors
Issue Date2014
PublisherAmerican Academy of Neurology (AAN).
Citation
The 66th Annual Meeting of the American Academy of Neurology (AAN 2014), Philadelphia, PA., 26 April-3 May 2014. How to Cite?
AbstractOBJECTIVE: To determine the prognostic implications of outpatient clinic visit-to-visit blood pressure variability (BPV) in patients with lacunar infarct. BACKGROUND: Both blood pressure (BP) and its variability (BPV) are established risk factors for development of atherosclerotic disease and are associated with an increased risk for cardiovascular and all-cause mortality. The prognostic implications of outpatient clinic visit-to-visit BPV amongst patients with lacunar infarction are nevertheless unknown. METHODS: We prospectively followed-up the clinical outcome of 281 patients with lacunar infarction. The average BP and BPV, as determined by the standard deviation of the systolic and diastolic BP, were recorded during a mean 13±6 outpatient clinic visits. RESULTS: The mean age of the population was 70±10 years. After a mean 78±18 month's follow-up, 65 patients died (23%), 31% (20/65) were due to cardiovascular causes. 14% and 7% developed recurrent stroke and acute coronary syndrome. After adjusting for age, sex, mean systolic and diastolic BP, cardiovascular risk factors and co-morbidities, patients with a systolic BPV of the third tertile had significantly higher risk of all-cause (hazards ratio [HR] 1.97, 95% confidence interval [CI] 1.02-3.80, P=0.04) and cardiovascular mortality (HR 7.64, 95% CI 1.65-35.41, P<0.01) compared to those with systolic BPV of the first tertile. Nevertheless, systolic BPV did not predict recurrent stroke or acute coronary syndrome. Diastolic BPV did not predict various adverse clinical outcomes. CONCLUSIONS: Visit-to-visit systolic BPV predicts long-term all-cause and cardiovascular mortality after lacunar infarct, independent of conventional risk factors including average BP control.
DescriptionPoster Session 6: Cerebrovascular Disease and Interventional Neurology: Risk Factors: abstract no. P6.274
Persistent Identifierhttp://hdl.handle.net/10722/198184

 

DC FieldValueLanguage
dc.contributor.authorLau, Gen_US
dc.contributor.authorWong, YKen_US
dc.contributor.authorChang, RSKen_US
dc.contributor.authorTeo, KCen_US
dc.contributor.authorHon, SFKen_US
dc.contributor.authorChan, KHen_US
dc.contributor.authorWat, KLen_US
dc.contributor.authorCheung, Ren_US
dc.contributor.authorLi, LSWen_US
dc.contributor.authorSiu, DCWen_US
dc.contributor.authorHo, SLen_US
dc.contributor.authorTse, HFen_US
dc.date.accessioned2014-06-25T02:51:55Z-
dc.date.available2014-06-25T02:51:55Z-
dc.date.issued2014en_US
dc.identifier.citationThe 66th Annual Meeting of the American Academy of Neurology (AAN 2014), Philadelphia, PA., 26 April-3 May 2014.en_US
dc.identifier.urihttp://hdl.handle.net/10722/198184-
dc.descriptionPoster Session 6: Cerebrovascular Disease and Interventional Neurology: Risk Factors: abstract no. P6.274-
dc.description.abstractOBJECTIVE: To determine the prognostic implications of outpatient clinic visit-to-visit blood pressure variability (BPV) in patients with lacunar infarct. BACKGROUND: Both blood pressure (BP) and its variability (BPV) are established risk factors for development of atherosclerotic disease and are associated with an increased risk for cardiovascular and all-cause mortality. The prognostic implications of outpatient clinic visit-to-visit BPV amongst patients with lacunar infarction are nevertheless unknown. METHODS: We prospectively followed-up the clinical outcome of 281 patients with lacunar infarction. The average BP and BPV, as determined by the standard deviation of the systolic and diastolic BP, were recorded during a mean 13±6 outpatient clinic visits. RESULTS: The mean age of the population was 70±10 years. After a mean 78±18 month's follow-up, 65 patients died (23%), 31% (20/65) were due to cardiovascular causes. 14% and 7% developed recurrent stroke and acute coronary syndrome. After adjusting for age, sex, mean systolic and diastolic BP, cardiovascular risk factors and co-morbidities, patients with a systolic BPV of the third tertile had significantly higher risk of all-cause (hazards ratio [HR] 1.97, 95% confidence interval [CI] 1.02-3.80, P=0.04) and cardiovascular mortality (HR 7.64, 95% CI 1.65-35.41, P<0.01) compared to those with systolic BPV of the first tertile. Nevertheless, systolic BPV did not predict recurrent stroke or acute coronary syndrome. Diastolic BPV did not predict various adverse clinical outcomes. CONCLUSIONS: Visit-to-visit systolic BPV predicts long-term all-cause and cardiovascular mortality after lacunar infarct, independent of conventional risk factors including average BP control.-
dc.languageengen_US
dc.publisherAmerican Academy of Neurology (AAN).-
dc.relation.ispartofAnnual Meeting of the American Academy of Neurology, AAN 2014en_US
dc.titleVisit-to-visit systolic blood pressure variability predicts all-cause and cardiovascular mortality after lacunar infarcten_US
dc.typeConference_Paperen_US
dc.identifier.emailLau, G: gkklau@hku.hken_US
dc.identifier.emailWong, YK: debbieyk@hku.hken_US
dc.identifier.emailChang, RSK: skrchang@hku.hken_US
dc.identifier.emailChan, KH: koonho@hku.hken_US
dc.identifier.emailWat, KL: dgwatkl@hku.hken_US
dc.identifier.emailCheung, R: rtcheung@hku.hken_US
dc.identifier.emailLi, LSW: lswli@hkucc.hku.hken_US
dc.identifier.emailSiu, DCW: cwdsiu@hkucc.hku.hken_US
dc.identifier.emailHo, SL: slho@hku.hken_US
dc.identifier.emailTse, HF: hftse@hkucc.hku.hken_US
dc.identifier.authorityLau, G=rp01499en_US
dc.identifier.authorityChan, KH=rp00537en_US
dc.identifier.authorityCheung, R=rp00434en_US
dc.identifier.authoritySiu, DCW=rp00534en_US
dc.identifier.authorityHo, SL=rp00240en_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.hkuros229265en_US
dc.publisher.placeUnited States-

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