| Prognostic value of hypotensive blood pressure response during single-stage exercise test on long-term outcome in patients with known or suspected peripheral arterial disease. | |
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MedLine Citation:
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PMID: 19005295 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: A decline in systolic blood pressure during exercise is thought to be a sign of severe coronary artery disease. However, no studies have yet examined this effect in patients with known or suspected peripheral arterial disease. Therefore, we investigated the prognostic value of hypotensive blood pressure response after single-stage exercise test on long-term mortality, major adverse cerebrovascular and cardiac events (MACCE) and the effects of statin, beta-blocker and aspirin use in patients with known or suspected peripheral arterial disease. METHODS: A total of 2022 patients were enrolled in an observational study with a mean follow-up of 5 years. Hypotensive blood pressure response, 4.6% of the total population, was defined as a drop in exercise systolic blood pressure below resting systolic blood pressure. RESULTS: Our study showed that hypotensive blood pressure response was associated with an increased risk of all-cause mortality [hazard ratio (HR): 1.74, 95% confidence interval (CI): 1.10-2.73] and MACCE (HR: 1.85, 95% CI: 1.14-3.00), independent of other clinical variables. Additionally, after adjustments for clinical risk factors and propensity score, baseline statin use was associated with a reduced risk of all-cause mortality (HR: 0.60, 95% CI: 0.44-0.80). Besides, statin and aspirin use were both also associated with a reduced risk of MACCE (HR: 0.65, 95% CI: 0.47-0.89 and HR: 0.69, 95% CI: 0.53-0.88, respectively). CONCLUSION: Hypotensive blood pressure response after single-stage treadmill exercise tests in patients with known or suspected peripheral arterial disease was associated with a higher risk for all-cause long-term mortality and MACCE, which might be reduced by statin and aspirin use. |
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Authors:
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Inge I de Liefde; Sanne E Hoeks; Yvette R B M van Gestel; Jan Klein; Hence J M Verhagen; Ron T van Domburg; Don Poldermans |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Coronary artery disease Volume: 19 ISSN: 1473-5830 ISO Abbreviation: Coron. Artery Dis. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-13 Completed Date: 2009-02-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9011445 Medline TA: Coron Artery Dis Country: England |
Other Details:
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Languages: eng Pagination: 603-7 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aged Aspirin / therapeutic use Blood Pressure* Cardiovascular Diseases / etiology*, mortality, physiopathology, prevention & control Exercise Test* Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Hypotension / etiology*, physiopathology Male Middle Aged Odds Ratio Peripheral Vascular Diseases / complications, diagnosis*, mortality, physiopathology, therapy Platelet Aggregation Inhibitors / therapeutic use Prognosis Proportional Hazards Models Risk Assessment Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin |
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