Prognostic Impact of Baseline Low Blood Pressure in Hypertensive Patients With Stable Coronary Artery Disease of Daily Clinical Practice
The Journal of Clinical Hypertension, 05/25/2012  Clinical Article

Ortiz MR et al. – A low first–visit systolic or diastolic blood pressure (SBP/DBP) was associated with an adverse prognosis in hypertensive patients with stable coronary artery disease (sCAD) of contemporary daily clinical practice.

• From February 1, 2000, to January 31, 2004, 690 consecutive hypertensive patients with sCAD (mean age 68±10 years, 65% male) were prospectively followed in the outpatient cardiology clinic for major events (acute coronary syndrome, revascularization, stroke, heart failure, or death) and associations with baseline SBP/DBP were investigated.

• At first visit, median SBP/SDP were 130/75 mm Hg (interquartile range, 25–75; 120–140/70–80 mm Hg).
• After 25 months of follow–up (median), 19 patients died (2.8%); 10 from cardiovascular causes (1.5%), 87 patients experienced a coronary event (13%), and 130 patients (19%) a major event.
• After adjusting for baseline variables, DBP <75 mm Hg or SBP <130 mm Hg resulted in independent predictors of major events (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.07–2.16, P=.02; HR, 1.68; 95% CI, 1.18–2.40, P=.004, respectively), coronary events (HR, 1.78; 95% CI, 1.15–2.75, P=.009; HR, 1.84; 95% CI, 1.20–2.83, P=.005, respectively), and cardiovascular mortality (HR, 7.02; 95% CI, 1.26–39.04, P=.03; HR, 9.26; 95% CI, 1.33–64.32, P=.02, respectively).