title: Arterial blood pressure is closely related to ascites development in compensated HCV-related cirrhosis.
abstract: BACKGROUND
  Arterial blood pressure (BP) is a reliable marker of circulatory dysfunction in cirrhotic patients. There are no prospective studies evaluating the association between different levels of arterial BP and ascites development in compensated cirrhotic patients. Therefore, we evaluated the relationship between arterial BP and ascites development in compensated cirrhotic patients.
  
  
  METHODS
  A total of 402 patients with compensated HCV-related cirrhosis were prospectively followed during 6 years to identify ascites development. At baseline, patients underwent systolic, diastolic and mean arterial pressure (MAP) measurements. Any history of arterial hypertension was also recorded. The occurrence of events such as bleeding, hepatocellular carcinoma, death and liver transplantation prior to ascites development were considered as competing risk events.
  
  
  RESULTS
  Over a median of 156 weeks, ascites occurred in 54 patients (13%). At baseline, MAP was significantly lower in patients with ascites development (75.9 mm/Hg [95%CI, 70.3-84.3]) than those without ascites (93.6 mm/Hg [95% CI: 86.6-102.3]). After adjusting for covariates, the 6-year cumulative incidence of ascites was 40% (95%CI, 34%-48%) for patients with MAP<83.32 mm/Hg. In contrast, cumulative incidences of ascites were almost similar among patients with MAP values between 83.32 mm/Hg and 93.32 mm/Hg (7% [95% CI: 4%-12%]), between 93.32 mm/Hg and 100.31 mm/Hg (5% [95% CI: 4%-11%]) or higher than 100.31 mm/Hg (3% [95% CI: 1%-6%]). The MAP was an independent predictor of ascites development.
  
  
  CONCLUSIONS
  The MAP is closely related to the development of ascites in compensated HCV-related cirrhosis. The risk of ascites development increases in 4.4 fold for subjects with MAP values <83.32 mm/Hg.
authors.affiliation: Department of Research and Clinical Experimentation, National Institute of Gastroenterology, Havana, Cuba.
authors.forename: Eduardo Vilar
authors.initials: EV
authors.lastname: Gomez
authors.affiliation: Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba.
authors.forename: Ana Torres
authors.initials: AT
authors.lastname: Gonzalez
authors.affiliation: Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba.
authors.forename: Luis Calzadilla
authors.initials: LC
authors.lastname: Bertot
authors.affiliation: Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba.
authors.forename: Ali
authors.initials: A
authors.lastname: Yasells Garcia
authors.affiliation: Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba.
authors.forename: Yoan Sanchez
authors.initials: YS
authors.lastname: Rodriguez
authors.affiliation: Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba.
authors.forename: Yadina Martinez
authors.initials: YM
authors.lastname: Perez
mesh_terms: D062186:Arterial Pressure; D001201:Ascites / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology*; D008297:Male; D011446:Prospective Studies
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