Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden

Palacios, Carlos R. Franco; Haugen, Eric; Thompson, Amanda M.; Rasmussen, Richard W.; Goracke, Nathan; Goyal, Pankaj

doi:10.1080/0886022x.2016.1227924

Cited by 5 publications

(2 citation statements)

References 17 publications

(12 reference statements)

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“…SBP is considered as an important parameter in the hypertensive population with prevalent cerebrovascular diseases [ 17 ]. Recent studies provided clinical evidence for a target SBP in elderly patients that was significantly associated with high risk of cardiovascular events [ 18 ]. So we propose preoperative SBPmax as a potential predictor of hypertension urgency in patients with APA within the first 24 hours post-operation.…”

Section: Discussionmentioning

confidence: 99%

Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery

et al. 2017

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Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed. The factors included gender, age, body mass index, preoperative maximum systolic blood pressure, number of antihypertensive medicines, preoperative spironolactone treatment, duration of hypertension, surgical method and approach, adenoma diameter, preoperative proteinuria, estimated glomerular filtration rate, serum potassium and serum aldosterone. Univariate and multivariate regression analyses were used to evaluate the relationship between the above variables and postoperative hypertension urgency. We found that the proportion of patients with a higher systolic blood pressure ≥ 160 mmHg and ≥ 180 mmHg were significantly increased post-operation (both p < 0.001). In multivariate analysis, the maximum systolic blood pressure was an independent predictor of postoperative hypertension urgency, and the cut-off point was 157 mmHg with the sensitivity of 66% and specificity of 82%. Multivariable analysis also showed that preoperative maximum systolic blood pressure and number of antihypertensive medicines were independent risk factors for higher postoperative systolic blood pressure. This study was derived from a high volume adrenal tumor center, and these data may provide a potential tool to guide preoperative counseling.

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Section: Discussionmentioning

confidence: 99%

Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery

et al. 2017

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“…Over 85% of cases have a papillary thyroid cancer (PTC) histotype and are generally associated with an excellent prognosis, with a 5-year survival rate of about 100% for localized, 98% for regional and 56% for metastatic disease (https://www.cancer.org/ research/cancer-facts-statistics/all-cancer-facts-figures/ cancer-facts-figures-2021.html) (3). However, up to 20% of DTC patients have persistent or recurrent disease (4,5). These tumors frequently spread to the lymph nodes (LN) of the neck compartment (12-81% of cases) (6,7).…”

Section: Introductionmentioning

confidence: 99%

Orbital metastasis from thyroid cancer: a case report and review of the literature

Sapuppo¹,

Martorana²,

Tirr³

et al. 2022

Ann Palliat Med

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Background: Differentiated thyroid cancer (DTC) is generally associated with an excellent prognosis.However up to 20% of DTC patients have disease events during subsequent follow-up; rarely patients present an aggressive disease with distant metastases (DM), mainly in the lung and bone. Metastases at unusual sites may also occur, generally in patients with disseminated disease. Orbital localization is rare and only few cases have been described so far.Case Description: A 36 years-old man, treated with chemo and radiotherapy during childhood for non-Hodgkin lymphoma, was referred for suspicious lymph node (LN) and multiple lung metastases. Total thyroidectomy and latero-cervical (LC) lymphadenectomy were performed: papillary thyroid cancer (PTC), 25 mm, 11/17 LN metastases; pT2N1bM1. Post-treatment total body scan with I-131 showed LN and lung uptake. Eighteen months from diagnosis he presented progressive diplopia, proptosis and right exophthalmos due to an 18 mm orbital metastasis. Hence, due to I-131 refractoriness for structural disease progression despite I-131 therapy, he started therapy with Lenvatinib for 6 months, with initial partial response followed by disease progression, and then with Cabozantinib, which he stopped after 6 months for adverse events and disease progression after therapy reduction. Currently, the patient is receiving Lenvatinib, rechallenge therapy, with disease stabilization and biochemical response. Molecular analysis, performed on both primary and relapsed tumor didn't show any significant pathogenic alteration.Conclusions: This case of DTC with an unusual metastasis in the orbit, may suggest that patient's exposure to chemo-and radiotherapy during pediatric age might have played a role in the subsequent development of this unusually aggressive tumor, reinforcing the recommendation of long-term and intensive follow-up of these patients.

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Continuous Outcomes

2018

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Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden

Abstract: A systolic blood pressure below 120 mmHg in older patients with high disease burden was associated with adverse outcomes. Individualization of blood pressure therapy to each specific patient is warranted.

Cited by 5 publications

References 17 publications

Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery

Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery

Orbital metastasis from thyroid cancer: a case report and review of the literature

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