Worse blood pressure control in patients with cerebrovascular or peripheral arterial disease compared with coronary artery disease

L. Mechtouff, E. Touzé, P. G. Steg, E. M. Ohman, S. Goto, A. T. Hirsch, J. Röther, F. T. Aichner, C. Weimar, D. L. Bhatt, M. J. Alberts, J. L. Mas

Research output: Contribution to journalArticle

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Abstract

Objectives. Poor blood pressure (BP) control is common amongst patients with symptomatic atherothrombotic disease. It is unclear whether BP control and management differ across atherothrombotic disease subtypes. Methods. We analysed the baseline data of 44 984 patients with documented coronary artery disease (CAD) only (n = 30 414), cerebrovascular disease (CVD) only (n = 11 359) and peripheral arterial disease (PAD) only (n = 3211) from the international REduction of Atherothrombosis for Continued Health Registry and investigated the impact of atherothrombotic disease subtype on BP control and use of antihypertensive drugs. Results. The proportion of patients with BP controlled (<140/90 mmHg) was higher in CAD (58.1%) than in CVD (44.8%) or PAD (38.9%) patients (P < 0.001). Amongst patients with treated hypertension, CAD patients were more likely to have BP controlled than were CVD patients [odds ratio (OR) = 1.67; 95% confidence interval (CI) = 1.59-1.75] or PAD (OR = 2.30; 95% CI = 2.10-2.52). These differences were smaller in women than in men and decreased with age. Amongst treated patients, CAD patients were more likely to receive ≥3-drug combination therapies than were CVD (OR = 1.73; 95% CI = 1.64-1.83) or PAD (OR = 1.64; 95% CI = 1.49-1.80) patients. Adjustment for age, gender, waist obesity, diabetes, education level and world region did not alter the results. Conclusions. Coronary artery disease patients are more likely than CVD or PAD patients to have BP controlled and to receive antihypertensive drugs, particularly combination therapies. Promotion of more effective BP control through combination antihypertensive therapies could improve secondary prevention and therefore prevent complications in CVD and PAD patients.

Original languageEnglish (US)
Pages (from-to)621-633
Number of pages13
JournalJournal of Internal Medicine
Volume267
Issue number6
DOIs
StatePublished - Jun 2010

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Peripheral Arterial Disease
Coronary Artery Disease
Blood Pressure
Cerebrovascular Disorders
Odds Ratio
Confidence Intervals
Antihypertensive Agents
Drug Combinations
Secondary Prevention
Combination Drug Therapy
Registries
Obesity

Keywords

  • Antihypertensive drugs
  • Blood pressure
  • Cerebrovascular disease
  • Coronary artery disease
  • Peripheral arterial disease

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Worse blood pressure control in patients with cerebrovascular or peripheral arterial disease compared with coronary artery disease. / Mechtouff, L.; Touzé, E.; Steg, P. G.; Ohman, E. M.; Goto, S.; Hirsch, A. T.; Röther, J.; Aichner, F. T.; Weimar, C.; Bhatt, D. L.; Alberts, M. J.; Mas, J. L.

In: Journal of Internal Medicine, Vol. 267, No. 6, 06.2010, p. 621-633.

Research output: Contribution to journalArticle

Mechtouff, L, Touzé, E, Steg, PG, Ohman, EM, Goto, S, Hirsch, AT, Röther, J, Aichner, FT, Weimar, C, Bhatt, DL, Alberts, MJ & Mas, JL 2010, 'Worse blood pressure control in patients with cerebrovascular or peripheral arterial disease compared with coronary artery disease', Journal of Internal Medicine, vol. 267, no. 6, pp. 621-633. https://doi.org/10.1111/j.1365-2796.2009.02198.x
Mechtouff, L. ; Touzé, E. ; Steg, P. G. ; Ohman, E. M. ; Goto, S. ; Hirsch, A. T. ; Röther, J. ; Aichner, F. T. ; Weimar, C. ; Bhatt, D. L. ; Alberts, M. J. ; Mas, J. L. / Worse blood pressure control in patients with cerebrovascular or peripheral arterial disease compared with coronary artery disease. In: Journal of Internal Medicine. 2010 ; Vol. 267, No. 6. pp. 621-633.
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abstract = "Objectives. Poor blood pressure (BP) control is common amongst patients with symptomatic atherothrombotic disease. It is unclear whether BP control and management differ across atherothrombotic disease subtypes. Methods. We analysed the baseline data of 44 984 patients with documented coronary artery disease (CAD) only (n = 30 414), cerebrovascular disease (CVD) only (n = 11 359) and peripheral arterial disease (PAD) only (n = 3211) from the international REduction of Atherothrombosis for Continued Health Registry and investigated the impact of atherothrombotic disease subtype on BP control and use of antihypertensive drugs. Results. The proportion of patients with BP controlled (<140/90 mmHg) was higher in CAD (58.1{\%}) than in CVD (44.8{\%}) or PAD (38.9{\%}) patients (P < 0.001). Amongst patients with treated hypertension, CAD patients were more likely to have BP controlled than were CVD patients [odds ratio (OR) = 1.67; 95{\%} confidence interval (CI) = 1.59-1.75] or PAD (OR = 2.30; 95{\%} CI = 2.10-2.52). These differences were smaller in women than in men and decreased with age. Amongst treated patients, CAD patients were more likely to receive ≥3-drug combination therapies than were CVD (OR = 1.73; 95{\%} CI = 1.64-1.83) or PAD (OR = 1.64; 95{\%} CI = 1.49-1.80) patients. Adjustment for age, gender, waist obesity, diabetes, education level and world region did not alter the results. Conclusions. Coronary artery disease patients are more likely than CVD or PAD patients to have BP controlled and to receive antihypertensive drugs, particularly combination therapies. Promotion of more effective BP control through combination antihypertensive therapies could improve secondary prevention and therefore prevent complications in CVD and PAD patients.",
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AU - Mechtouff, L.

AU - Touzé, E.

AU - Steg, P. G.

AU - Ohman, E. M.

AU - Goto, S.

AU - Hirsch, A. T.

AU - Röther, J.

AU - Aichner, F. T.

AU - Weimar, C.

AU - Bhatt, D. L.

AU - Alberts, M. J.

AU - Mas, J. L.

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N2 - Objectives. Poor blood pressure (BP) control is common amongst patients with symptomatic atherothrombotic disease. It is unclear whether BP control and management differ across atherothrombotic disease subtypes. Methods. We analysed the baseline data of 44 984 patients with documented coronary artery disease (CAD) only (n = 30 414), cerebrovascular disease (CVD) only (n = 11 359) and peripheral arterial disease (PAD) only (n = 3211) from the international REduction of Atherothrombosis for Continued Health Registry and investigated the impact of atherothrombotic disease subtype on BP control and use of antihypertensive drugs. Results. The proportion of patients with BP controlled (<140/90 mmHg) was higher in CAD (58.1%) than in CVD (44.8%) or PAD (38.9%) patients (P < 0.001). Amongst patients with treated hypertension, CAD patients were more likely to have BP controlled than were CVD patients [odds ratio (OR) = 1.67; 95% confidence interval (CI) = 1.59-1.75] or PAD (OR = 2.30; 95% CI = 2.10-2.52). These differences were smaller in women than in men and decreased with age. Amongst treated patients, CAD patients were more likely to receive ≥3-drug combination therapies than were CVD (OR = 1.73; 95% CI = 1.64-1.83) or PAD (OR = 1.64; 95% CI = 1.49-1.80) patients. Adjustment for age, gender, waist obesity, diabetes, education level and world region did not alter the results. Conclusions. Coronary artery disease patients are more likely than CVD or PAD patients to have BP controlled and to receive antihypertensive drugs, particularly combination therapies. Promotion of more effective BP control through combination antihypertensive therapies could improve secondary prevention and therefore prevent complications in CVD and PAD patients.

AB - Objectives. Poor blood pressure (BP) control is common amongst patients with symptomatic atherothrombotic disease. It is unclear whether BP control and management differ across atherothrombotic disease subtypes. Methods. We analysed the baseline data of 44 984 patients with documented coronary artery disease (CAD) only (n = 30 414), cerebrovascular disease (CVD) only (n = 11 359) and peripheral arterial disease (PAD) only (n = 3211) from the international REduction of Atherothrombosis for Continued Health Registry and investigated the impact of atherothrombotic disease subtype on BP control and use of antihypertensive drugs. Results. The proportion of patients with BP controlled (<140/90 mmHg) was higher in CAD (58.1%) than in CVD (44.8%) or PAD (38.9%) patients (P < 0.001). Amongst patients with treated hypertension, CAD patients were more likely to have BP controlled than were CVD patients [odds ratio (OR) = 1.67; 95% confidence interval (CI) = 1.59-1.75] or PAD (OR = 2.30; 95% CI = 2.10-2.52). These differences were smaller in women than in men and decreased with age. Amongst treated patients, CAD patients were more likely to receive ≥3-drug combination therapies than were CVD (OR = 1.73; 95% CI = 1.64-1.83) or PAD (OR = 1.64; 95% CI = 1.49-1.80) patients. Adjustment for age, gender, waist obesity, diabetes, education level and world region did not alter the results. Conclusions. Coronary artery disease patients are more likely than CVD or PAD patients to have BP controlled and to receive antihypertensive drugs, particularly combination therapies. Promotion of more effective BP control through combination antihypertensive therapies could improve secondary prevention and therefore prevent complications in CVD and PAD patients.

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KW - Blood pressure

KW - Cerebrovascular disease

KW - Coronary artery disease

KW - Peripheral arterial disease

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