Key result
High systolic blood pressure variation is linked to ~119% higher odds of adverse events.
Why the study?
The correlation between blood pressure change patterns and prognosis in patients with aortic dissection remains unclear.
Do specific systolic blood pressure change patterns and high blood pressure variation in the first 30 minutes after admission predict early adverse events in patients with aortic dissection?
Cohort (n=458)
Yes
Do specific systolic blood pressure change patterns and high blood pressure variation in the first 30 minutes after admission predict early adverse events in patients with aortic dissection?
Answers are grounded in this paper and cite their sources.
In patients with aortic dissection, high systolic blood pressure variation and an accelerating rise in blood pressure during the first 30 minutes of admission are associated with a higher risk of early adverse events.
Objectives Hypertension is a predominant risk factor for aortic dissection (AD), and blood pressure (BP) control plays a vital role in the management of AD. However, the correlation between BP change and the prognosis for AD remains unclear. This study aims to demonstrate the impact of BP change patterns on AD prognosis. Methods This retrospective study included AD patients at two institutions (Shanghai Ninth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine and the Vascular Department of the First Affiliated Hospital of Anhui Medical University) between 2004 and 2018. The systolic BP (SBP) change patterns of these patients were analyzed by functional data analysis (FDA). The relationship between BP change patterns and the risk of adverse events (AEs) was assessed using survival analysis. Results A total of 458 patients with AD were eligible for analysis. The logistic regression analysis indicated that compared with that in patients with low SBP variation (SBPV), the incidence of AEs in patients with high SBPV was significantly higher (35.84 vs. 20.35%, OR 2.19, P < 0.001). The patients were divided into four categories (accelerating rise, accelerating drop, decelerating rise, and decelerating drop) based on their SBP patterns after FDA fitting. The results of Kaplan–Meier analysis showed that at the 15- and 20-min time points, the incidence of AEs in the decelerating-drop group was significantly lower than that in the accelerating-rise group (OR 0.19, P = 0.031 and OR 0.23, P = 0.050). However, at the 25- and 30-min time points, the difference between these four groups was not significant (OR 0.26, P = 0.08 and OR 0.29, P = 0.10). Conclusions This study classified AD patients into four groups according to the SBP change patterns the first 30 min following admission, of which those with accelerating rises in SBP are at the highest risk of AEs, while those with decelerating drops have the best prognosis in the first 24 h after admission. Clinical practitioners may benefit from analyzing patterns of in-hospital SBP.
No takes yet. Share an insight, caveat, or question.
Wu et al. (2022) conducted a cohort in Aortic dissection (n=458). High systolic blood pressure variation (SBPV) vs. Low SBPV was evaluated on Adverse events (AEs) (OR 2.19, p=< 0.001). High systolic blood pressure variation was associated with a significantly higher incidence of adverse events compared to low variation (35.84% vs. 20.35%, OR 2.19, P<0.001).
Synapse has enriched 10 related papers. Consider them for comparative context: