Optimal blood pressure in patients with peripheral artery disease following endovascular therapy
Haruki Sasaki1, Nobuyuki Ura2, Shinya Hata1
1a Division of Cardiology , Cardiovascular Center, Teine Keijinkai Hospital , Sapporo , Japan.
Insights
Maintaining optimal blood pressure (BP) below 140/90 mmHg after endovascular therapy (EVT) is crucial. Lower BP significantly reduces restenosis rates, highlighting the importance of managing hypertension and diabetes post-EVT.
Area of Science:
- Cardiovascular Medicine
- Interventional Radiology
- Endovascular Therapy
Background:
- Endovascular therapy (EVT) is a common treatment for vascular diseases.
- Optimal blood pressure (BP) management post-EVT is not well-defined.
- Hypertension and diabetes are common comorbidities affecting EVT outcomes.
Purpose of the Study:
- To investigate the association between BP levels and event incidence after EVT.
- To determine optimal BP targets for reducing adverse events, particularly restenosis.
- To explore the role of diabetes management in conjunction with BP control.
Main Methods:
- Retrospective analysis of patients undergoing EVT.
- BP monitoring every 6 months for 5 years.
- Patients grouped by average BP: ≥140/90 mmHg vs. <140/90 mmHg.
Main Results:
- No significant difference in total mortality between BP groups.
- Restenosis rates were significantly higher in the ≥140/90 mmHg group (36.2%) compared to the <140/90 mmHg group (18.2%).
- Higher glycosylated hemoglobin (>7.0%) and metformin use were observed in the restenosis group, suggesting a link with severe diabetes.
Conclusions:
- Achieving target BP (<140/90 mmHg) after EVT is critical for preventing restenosis.
- Effective management of both hypertension and diabetes is essential for improving outcomes post-EVT.
- Further research may explore specific interventions for diabetic patients undergoing EVT.
Abstract:
This study examined the associations between blood pressure (BP) and event incidence to define optimal BP after endovascular therapy (EVT) in patients who underwent EVT. BP was monitored every 6 months for 5 years, and the patients were divided into two groups by average BP: ≥ 140/90 mmHg and < 140/90 mmHg. The association of BP with several events was examined. Although no significant differences in total mortality were observed between the groups, restenosis rates were significantly higher among patients who did not achieve target BP (36.2%) than among those who did (18.2%) (p < 0.01). The percentage of patients with glycosylated haemoglobin > 7.0% was significantly higher among those who did not achieve target BP in the restenosis group (42.9%) than in the other group (10.8%) (p < 0.01). In the restenosis group, there was a significantly higher percentage of patients taking metformin (p < 0.01) than in the other group. Metformin seemed to be administered to patients with more severe diabetes mellitus. In conclusion, it is important to manage hypertension and diabetes to prevent restenosis after EVT.
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