Document Detail


Lack of impact of pulse pressure on outcomes in patients with malignant phase hypertension: the West Birmingham Malignant Hypertension study.
MedLine Citation:
PMID:  22495136     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : To investigate the impact of pulse pressure at presentation on the primary outcome (death or dialysis) in patients with malignant phase hypertension (MPH).
METHODS: : Three hundred and sixty-five patients [overall mean (SD) age 48 (13) years; 66% male; 63% white European; 23% African-Caribbean, 14% south Asian] from the West Birmingham MPH study were included. Baseline pulse pressure was divided into quartiles. Two hundred and forty-two primary outcomes (death or dialysis) occurred during a median (interquartile range) follow-up of 7 (1.5-14.8) years.
RESULTS: : Significantly higher pulse pressure was evident among older patients and white Europeans. Baseline BMI (P = 0.49), retinopathy (P = 0.56), proteinuria (P = 0.61), haematuria (P = 0.56) and left ventricular hypertrophy (P = 0.43) were not related to pulse pressure. Multivariate analyses found that baseline age [hazard ratio (95% confidence intervals] [1.05 (1.04-1.06); P < 0.0001], smoking [1.60 (1.16-2.21); P = 0.004], proteinuria [1.33 (1.10-1.61); P = 0.003] and creatinine level [1.002 (1.001-1.002); P < 0.0001] were independent predictors of the primary outcome of 'death or dialysis'. A multivariate analysis also revealed that independent predictors of future dialysis alone were as follows: baseline age [0.92 (0.89-0.95); P < 0.001) and haematuria [2.74 (1.17-6.42); P = 0.02), with a trend seen for baseline creatinine levels [1.001 (1.000-1.002); P = 0.052)]. Pulse pressure at baseline did not predict death or dialysis.
CONCLUSION: : Age, smoking status and severity of renal failure at presentation with MPH (represented by proteinuria and creatinine levels) are independent predictors of the risk of death or dialysis. Pulse pressure at presentation does not predict death or dialysis in patients with MPH. Careful monitoring of renal functioning and effective management of blood pressure is mandatory in patients with MPH to prevent/slow future complications.
Authors:
Alena Shantsila; Deirdre A Lane; D Gareth Beevers; Gregory Y H Lip
Related Documents :
11503076 - Effects of mercury on the contractile activity of the right ventricular myocardium.
7494556 - Factors involved in capillary growth in the heart.
3789176 - Studies of functional site of origin of native coronary collaterals.
9532006 - Immunopathological mechanisms underlying the time-course of trichinella spiralis cardio...
19020426 - Validation of the am5600 ambulatory blood pressure monitor in children and adolescents.
7359356 - Protective effects of dimethyl-propranolol (um-272) during global ischemia of isolated ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  30     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  974-9     Citation Subset:  IM    
Affiliation:
University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK 1Alena Shantsila and Deirdre A. Lane contributed equally to the writing of this article.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patien...
Next Document:  Normal values of left-ventricular mass: echocardiographic findings from the PAMELA study.