Impact of in-hospital blood pressure variability on clinical outcomes in patients with symptomatic peripheral arterial disease

Suzuki, Masahiro; Saito, Yuichi; Kitahara, Hideki; Saito, Kan; Takahara, Masayuki; Himi, Toshiharu; Kobayashi, Yoshio

doi:10.1038/s41440-021-00648-8

Cited by 6 publications

(10 citation statements)

References 37 publications

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“…The BP variability was also evaluated in this study as a possible mechanism of coronary atherosclerosis and worse cardiovascular outcomes in patients with hyperuricemia. The in-hospital BP variability is a recently emerged index of the BP fluctuation, and we and others reported that it was associated with cardiovascular outcomes in patients with a CAD, a peripheral artery disease, and stroke [ 17 , 18 , 23 ]. Because the BP is routinely measured during hospitalization, in daily practice, the in-hospital BP variability can be readily available.…”

Section: Discussionmentioning

confidence: 99%

“…The BP variability during the hospitalization was investigated, as was accomplished in the present studies [ 17 , 18 ]. During the hospitalization for the PCI and coronary angiography, the BP and pulse rate were measured by trained nurses using an automated cuff sphygmomanometer (ES-H55 and ES-H56, Terumo, Tokyo, Japan) at 6:00 AM, 2:00 PM, and 5:00 PM in a routine clinical setting.…”

Section: Methodsmentioning

confidence: 99%

“…The in-hospital BP variability was evaluated with the standard deviation (SD) and coefficient of variation (CV) of the systolic BP throughout the hospitalization. The CV was defined as the within-subject SD × 100 divided by the average BP level [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

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Systemic Endothelial Function, Plasma Xanthine Oxidoreductase Activity, and Blood Pressure Variability in Patients with Stable Coronary Artery Disease

et al. 2022

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Background and Objectives: Although previous studies showed that an activity of xanthine oxidoreductase (XOR), a rate-limiting enzyme in purine metabolism, beyond the serum uric acid level, was associated with the development of coronary artery disease (CAD), the underlying mechanisms are unclear. Because endothelial dysfunction and a greater blood pressure (BP) variability may play a role, we investigated the relations among the endothelial function, XOR, and BP variability. Materials and Methods: This was a post-hoc study using pooled data of patients with a stable CAD from two prospective investigations, in which the systemic endothelial function was assessed with the reactive hyperemia index (RHI) and the XOR activity was measured. The BP variability was evaluated using BP measurements during the three- and four-day hospitalization. Results: A total of 106 patients with a stable CAD undergoing a percutaneous coronary intervention were included. Of the 106 patients, 46 (43.4%) had a systemic endothelial dysfunction (RHI < 1.67). The multivariable analysis identified a higher body mass index (BMI), female gender, and diabetes as factors associated with an endothelial dysfunction. A higher BMI was also related to an elevated XOR activity, in addition to current smoking. No significant correlation was observed between the RHI and XOR activity. Similarly, the in-hospital BP variability was associated with neither the endothelial function nor XOR. Conclusions: Among patients with a stable CAD, several factors were identified as being associated with a systemic endothelial dysfunction or an elevated XOR activity. However, no direct relations between the endothelial function, XOR, and BP variability were found.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Systemic Endothelial Function, Plasma Xanthine Oxidoreductase Activity, and Blood Pressure Variability in Patients with Stable Coronary Artery Disease

et al. 2022

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“…CV was defined as the within-subject SD×100 divided by the mean BP level. [18][19][20] BP measurement≥3 times allowed us to evaluate visit-to-visit BP variability and to calculate SD and CV of systolic BP. 21 22 Mean PR and SD and CV of PR were also assessed.…”

Section: Methods Study Design and Participantsmentioning

confidence: 99%

“…In the present analysis, visit-to-visit BP variability was evaluated by SD and coefficient of variation (CV) of systolic BP. CV was defined as the within-subject SD×100 divided by the mean BP level 18–20. BP measurement≥3 times allowed us to evaluate visit-to-visit BP variability and to calculate SD and CV of systolic BP 21 22.…”

Section: Methodsmentioning

confidence: 99%

Impact of febuxostat on visit-to-visit blood pressure variability: insights from the randomised PRIZE Study

et al. 2022

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Objectives Although uric acid lowering therapies, including xanthine oxidase (XO) inhibition, may reduce the absolute level of blood pressure (BP), the effect of XO inhibition on BP variability is largely unknown. The aim of the present analysis was to evaluate the impact of febuxostat, an XO inhibitor, on BP variability in a randomised trial setting. Methods This was a subanalysis of the PRIZE Study, a randomised trial to evaluate the potential effect of febuxostat on carotid intima-media thickness progression. Patients with hyperuricemia and carotid plaques were randomly assigned to the febuxostat or control group. During a 24-month period, office BP and pulse rate (PR) were measured ≥3 times. BP and PR variabilities were assessed with SD and coefficient of variation (CV). The effect of febuxostat on BP and PR variabilities was adjusted with age, sex and baseline BP or PR, expressed with 95% CIs. Results A total of 472 patients were included into the present subanalysis. During the 24-month follow-up period, the febuxostat group had a significantly lower adjusted mean systolic 2) mm Hg, p=0.04) and CV of systolic BP (7.4 (6.7-8.0) vs 8.2 (7.6-8.8), p=0.04) than the control group. Adjusted SD of PR was also lower in the febuxostat group than their counterpart (5.95 (4.93-6.97) vs 7.33 (6.32-8.33), p=0.04). Conclusion XO inhibition with febuxostat was associated with reduced visit-to-visit BP variability as well as reduced PR variability in patients with hyperuricemia and carotid plaques.

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Importance of anemia in heart failure over blood pressure variability

Kiuchi,

Hisatake,

Kabuki

et al. 2023

Clinical Cardiology

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BackgroundThe evaluation of arteriosclerosis (vascular function) is important when treating heart failure (HF). Vascular dysfunction is associated with anemia through renal function and endothelial nitric oxide synthase. Additionally, blood pressure (BP) variability (BPV) caused by vascular dysfunction is also associated with HF prognosis. However, how anemia and BPV may affect HF prognosis is unclear.MethodsBetween January 2012 and July 2018, 214 patients with HF were hospitalized. The cardio‐ankle vascular index (CAVI) as an index of arteriosclerosis of these patients was measured. The patients were divided into the elevated and preserved CAVI groups. We investigated the factors related to major adverse cardiovascular events (MACEs) as cardiovascular death or rehospitalization within 1 year after discharge.ResultsIn the elevated CAVI group, significant differences in body mass index (BMI), BPV, left ventricular dimension, and hemoglobin levels were observed between patients with and without MACEs. In the preserved CAVI group, significant differences in BMI, diastolic/mean BP, and hemoglobin levels were observed between those with and without MACEs. The multivariate analysis showed an independent association between hemoglobin levels and MACE occurrence in both the elevated and preserved CAVI groups (elevated CAVI group: hazard ratio [HR] = 0.800, p = .045 [model 1], HR = 0.802, p = .035 [model 2]; preserved CAVI group: HR = 0.783, p = .049 [model 1], HR = 0.752, p = .023 [model 2], and HR = 0.754, p = .024 [model 3]).ConclusionsAnemia was independently associated with HF prognosis with or without arteriosclerosis.

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Impact of in-hospital blood pressure variability on clinical outcomes in patients with symptomatic peripheral arterial disease

Cited by 6 publications

References 37 publications

Systemic Endothelial Function, Plasma Xanthine Oxidoreductase Activity, and Blood Pressure Variability in Patients with Stable Coronary Artery Disease

Systemic Endothelial Function, Plasma Xanthine Oxidoreductase Activity, and Blood Pressure Variability in Patients with Stable Coronary Artery Disease

Impact of febuxostat on visit-to-visit blood pressure variability: insights from the randomised PRIZE Study

Importance of anemia in heart failure over blood pressure variability

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