AustralieFrV1, Main, Exploration, bibRecord, 005775

Visit-to-Visit Blood Pressure Variability Is a Strong Predictor of Cardiovascular Events in Hemodialysis Insights From FOSIDIAL

Identifieur interne : 005775 ( Main/Exploration ); précédent : 005774; suivant : 005776

Visit-to-Visit Blood Pressure Variability Is a Strong Predictor of Cardiovascular Events in Hemodialysis Insights From FOSIDIAL

Auteurs : Patrick Rossignol [France] ; Joelle Cridlig [France] ; Philippe Lehert [Belgique, Australie] ; Michele Kessler [France] ; Faiez Zannad [France]

Source :

Hypertension : (Dallas, Tex. 1979) [ 0194-911X ] ; 2012.

RBID : Pascal:12-0305627

Descripteurs français

Pascal (Inist)
- Insuffisance rénale, Pathologie de l'appareil circulatoire, Pression artérielle, Pression sanguine, Variabilité, Hémodialyse, Pronostic, Hypertension artérielle.

English descriptors

KwdEn :
- Arterial pressure, Blood pressure, Cardiovascular disease, Hemodialysis, Hypertension, Prognosis, Renal failure, Variability.

Abstract

Optimal blood pressure (BP) targets are still controversial in end-stage renal disease. Recent data have highlighted shortcomings of the usual BP hypothesis in other patient populations and emphasized the importance of visit-to-visit variability of BP in predicting cardiovascular events. The Fosinopril in Dialysis Study failed to demonstrate the efficacy of 2-year angiotensin-converting enzyme inhibition with fosinopril versus placebo in 397 hemodialysis patients with left ventricular hypertrophy but provided an opportunity to assess the influence of BP variability on cardiovascular events. The primary end point was the occurrence of a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina, stroke, revascularization, hospitalization for heart failure, and resuscitated cardiac arrest. The variations in BP throughout the 17 visits were assessed by within-patient overall variability of systolic, diastolic, and pulse pressures between adjacent readings, by within-patient overall variability of systolic/ diastolic/pulse pressures, and the residual of the linear fit. Compared with our previous predictive model of cardiovascular events occurrence based on stroke, peripheral arterial disease, coronary artery disease, diabetes mellitus, left ventricular mass, and age (which exhibited similar coefficients herein), the percentage of explained variance improved by 30.1% (R²=0.141-0.183) when adding the coefficient of variation of within-patient overall variability of systolic BP. Usual BP parameters were neither cardiovascular events predictors nor correlated to BP variability. Visit-to-visit BP variability was extremely high in hemodialysis patients compared with other populations and a major determinant of cardiovascular events. Such assessments should be prioritized for testing prevention strategies in end-stage renal disease.

Affiliations:

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Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arterial pressure</term>
<term>Blood pressure</term>
<term>Cardiovascular disease</term>
<term>Hemodialysis</term>
<term>Hypertension</term>
<term>Prognosis</term>
<term>Renal failure</term>
<term>Variability</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Insuffisance rénale</term>
<term>Pathologie de l'appareil circulatoire</term>
<term>Pression artérielle</term>
<term>Pression sanguine</term>
<term>Variabilité</term>
<term>Hémodialyse</term>
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<front><div type="abstract" xml:lang="en">Optimal blood pressure (BP) targets are still controversial in end-stage renal disease. Recent data have highlighted shortcomings of the usual BP hypothesis in other patient populations and emphasized the importance of visit-to-visit variability of BP in predicting cardiovascular events. The Fosinopril in Dialysis Study failed to demonstrate the efficacy of 2-year angiotensin-converting enzyme inhibition with fosinopril versus placebo in 397 hemodialysis patients with left ventricular hypertrophy but provided an opportunity to assess the influence of BP variability on cardiovascular events. The primary end point was the occurrence of a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina, stroke, revascularization, hospitalization for heart failure, and resuscitated cardiac arrest. The variations in BP throughout the 17 visits were assessed by within-patient overall variability of systolic, diastolic, and pulse pressures between adjacent readings, by within-patient overall variability of systolic/ diastolic/pulse pressures, and the residual of the linear fit. Compared with our previous predictive model of cardiovascular events occurrence based on stroke, peripheral arterial disease, coronary artery disease, diabetes mellitus, left ventricular mass, and age (which exhibited similar coefficients herein), the percentage of explained variance improved by 30.1% (R<sup>2</sup>
=0.141-0.183) when adding the coefficient of variation of within-patient overall variability of systolic BP. Usual BP parameters were neither cardiovascular events predictors nor correlated to BP variability. Visit-to-visit BP variability was extremely high in hemodialysis patients compared with other populations and a major determinant of cardiovascular events. Such assessments should be prioritized for testing prevention strategies in end-stage renal disease.</div>
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<orgName><li>Université de Lorraine</li>
<li>Université de Melbourne</li>
</orgName>
</list>
<tree><country name="France"><region name="Grand Est"><name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name>
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<name sortKey="Cridlig, Joelle" sort="Cridlig, Joelle" uniqKey="Cridlig J" first="Joelle" last="Cridlig">Joelle Cridlig</name>
<name sortKey="Kessler, Michele" sort="Kessler, Michele" uniqKey="Kessler M" first="Michele" last="Kessler">Michele Kessler</name>
<name sortKey="Kessler, Michele" sort="Kessler, Michele" uniqKey="Kessler M" first="Michele" last="Kessler">Michele Kessler</name>
<name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name>
<name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name>
<name sortKey="Rossignol, Patrick" sort="Rossignol, Patrick" uniqKey="Rossignol P" first="Patrick" last="Rossignol">Patrick Rossignol</name>
<name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name>
<name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name>
<name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name>
<name sortKey="Zannad, Faiez" sort="Zannad, Faiez" uniqKey="Zannad F" first="Faiez" last="Zannad">Faiez Zannad</name>
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<country name="Belgique"><noRegion><name sortKey="Lehert, Philippe" sort="Lehert, Philippe" uniqKey="Lehert P" first="Philippe" last="Lehert">Philippe Lehert</name>
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<country name="Australie"><region name="Victoria (État)"><name sortKey="Lehert, Philippe" sort="Lehert, Philippe" uniqKey="Lehert P" first="Philippe" last="Lehert">Philippe Lehert</name>
</region>
</country>
</tree>
</affiliations>
</record>

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{{Explor lien
   |wiki=    Wicri/Asie
   |area=    AustralieFrV1
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   |étape=   Exploration
   |type=    RBID
   |clé=     Pascal:12-0305627
   |texte=   Visit-to-Visit Blood Pressure Variability Is a Strong Predictor of Cardiovascular Events in Hemodialysis Insights From FOSIDIAL
}}

This area was generated with Dilib version V0.6.33.
Data generation: Tue Dec 5 10:43:12 2017. Site generation: Tue Mar 5 14:07:20 2024

	Serveur d'exploration sur les relations entre la France et l'Australie
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Serveur d'exploration sur les relations entre la France et l'Australie

Visit-to-Visit Blood Pressure Variability Is a Strong Predictor of Cardiovascular Events in Hemodialysis Insights From FOSIDIAL

Visit-to-Visit Blood Pressure Variability Is a Strong Predictor of Cardiovascular Events in Hemodialysis Insights From FOSIDIAL

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