title: Hypertension and Stroke in Patients with Left Ventricular Assist Devices (LVADs).
abstract: Stroke is one of the most dreaded complications of left ventricular assist device therapy in patients with end-stage congestive heart failure. There is strong evidence linking anticoagulation and infection with ischemic and hemorrhagic strokes, though recent data has emerged regarding the importance of elevated blood pressure. In the recently completed Heartware Ventricular Assist Device studies, a mean arterial pressure greater than 90 mmHg was associated with greater stroke risk, particularly the hemorrhagic subtype. In this review, we discuss recent evidence regarding deleterious effects of uncontrolled hypertension in patients with left ventricular devices, and propose measurement and management strategies.
authors.affiliation: Department of Neurology, Division of Stroke and Cerebrovascular Diseases, Columbia University, New York, NY, USA. jzw2@cumc.columbia.edu.
authors.forename: Joshua Z
authors.initials: JZ
authors.lastname: Willey
authors.affiliation: Department of Neurology, Division of Neurology Clinical Outcomes Research and Population Science, Columbia University, New York, NY, USA.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castagna
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA.
authors.forename: Melana
authors.initials: M
authors.lastname: Yuzefpolskaya
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA.
authors.forename: A Reshad
authors.initials: AR
authors.lastname: Garan
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA.
authors.forename: Veli
authors.initials: V
authors.lastname: Topkara
authors.affiliation: Department of Medicine, Division of Cardiology, Columbia University, New York, NY, USA.
authors.forename: Paolo C
authors.initials: PC
authors.lastname: Colombo
mesh_terms: D062186:Arterial Pressure; D006353:Heart-Assist Devices; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000503:physiopathology*
keywords: Hypertension; Left ventricular assist device; Stroke