title: Prognostic impact of baseline low blood pressure in hypertensive patients with stable coronary artery disease of daily clinical practice.
abstract: The authors' aim was to investigate the prognostic value of first-visit systolic and diastolic blood pressure (SBP/DBP) in hypertensive patients with stable coronary artery disease (sCAD) in conditions of contemporary daily clinical practice. From February 1, 2000, to January 31, 2004, 690 consecutive hypertensive patients with sCAD (mean age 68 ± 10 years, 65% male) were prospectively followed in the outpatient cardiology clinic for major events (acute coronary syndrome, revascularization, stroke, heart failure, or death) and associations with baseline SBP/DBP were investigated. At first visit, median SBP/SDP were 130/75 mm Hg (interquartile range, 25-75; 120-140/70-80 mm Hg). After 25 months of follow-up (median), 19 patients died (2.8%); 10 from cardiovascular causes (1.5%), 87 patients experienced a coronary event (13%), and 130 patients (19%) a major event. After adjusting for baseline variables, DBP <75 mm Hg or SBP <130 mm Hg resulted in independent predictors of major events (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.07-2.16, P=.02; HR, 1.68; 95% CI, 1.18-2.40, P=.004, respectively), coronary events (HR, 1.78; 95% CI, 1.15-2.75, P=.009; HR, 1.84; 95% CI, 1.20-2.83, P=.005, respectively), and cardiovascular mortality (HR, 7.02; 95% CI, 1.26-39.04, P=.03; HR, 9.26; 95% CI, 1.33-64.32, P=.02, respectively). In this study, a low first-visit SBP or DBP was associated with an adverse prognosis in hypertensive patients with sCAD of contemporary daily clinical practice.
authors.affiliation: Department of Cardiology, Reina Sofía University Hospital, Córdoba, Spain. maruor@gmail.com
authors.forename: Martín Ruiz
authors.initials: MR
authors.lastname: Ortiz
authors.forename: Elías
authors.initials: E
authors.lastname: Romo
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado
authors.forename: Cristina
authors.initials: C
authors.lastname: Ogayar
authors.forename: Manuel
authors.initials: M
authors.lastname: Anguita
authors.forename: Juan C
authors.initials: JC
authors.lastname: Castillo
authors.forename: José M
authors.initials: JM
authors.lastname: Arizón
authors.forename: José Suárez
authors.initials: JS
authors.lastname: de Lezo
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D003971:Diastole / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009819:Office Visits; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate; D013599:Systole / Q000502:physiology