Document Detail


Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects: the PARTAGE (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population) study.
MedLine Citation:
PMID:  22999729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the longitudinal PARTAGE study was to determine the predictive value of blood pressure (BP) and pulse pressure amplification, a marker of arterial function, for overall mortality (primary endpoint) and major cardiovascular (CV) events, in subjects older than 80 years of age living in a nursing home.
BACKGROUND: Assessment of pulse indexes may be important in the evaluation of the CV risk in very elderly frail subjects.
METHODS: A total of 1,126 subjects (874 women) who were living in French and Italian nursing homes were enrolled (mean age, 88 ± 5 years). Central (carotid) to peripheral (brachial) pulse pressure amplification (PPA) was calculated with the help of an arterial tonometer. Clinical and 3-day self-measurements of BP were conducted.
RESULTS: During the 2-year follow-up, 247 subjects died, and 228 experienced major CV events. The PPA was a predictor of total mortality and major CV events in this population. A 10% increase in PPA was associated with a 24% (p < 0.0003) decrease in total mortality and a 17% (p < 0.01) decrease in major CV events. Systolic BP, diastolic BP, or pulse pressure were either not associated or inversely correlated with total mortality and major CV events.
CONCLUSIONS: In very elderly individuals living in nursing homes, low PPA from central to peripheral arteries strongly predicts mortality and adverse effects. Assessment of this parameter could help in risk estimation and improve diagnostic and therapeutic strategies in very old, polymedicated persons. In contrast, high BP is not associated with higher risk of mortality or major CV events in this population. (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population [PARTAGE]; NCT00901355).
Authors:
Athanase Benetos; Sylvie Gautier; Carlos Labat; Paolo Salvi; Filippo Valbusa; Francesca Marino; Olivier Toulza; Davide Agnoletti; Mauro Zamboni; Delphine Dubail; Patrick Manckoundia; Yves Rolland; Olivier Hanon; Christine Perret-Guillaume; Patrick Lacolley; Michel E Safar; Francis Guillemin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-09-19
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-12     Completed Date:  2012-12-28     Revised Date:  2013-01-11    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1503-11     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Inserm U961, Nancy, France. a.benetos@chu-nancy.fr
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00901355
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Blood Pressure*
Cardiovascular Diseases / diagnosis,  mortality*,  physiopathology
Female
France / epidemiology
Humans
Italy / epidemiology
Longitudinal Studies
Male
Nursing Homes
Predictive Value of Tests
Prognosis
Pulse Wave Analysis*
Comments/Corrections
Comment In:
Nat Rev Cardiol. 2012 Dec;9(12):672   [PMID:  23070231 ]

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


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