High Pulse Pressure Associated With Cardiovascular Events in Patients With Type 2 Diabetes Undergoing Hemodialysis

Foucan, Lydia; Deloumeaux, Jacqueline; Foucan, Tania; Blanchet-Deverly, Anne; Merault, Henry; Gabriel, Jean-Marc; Hiesse, C

doi:10.1016/j.amjhyper.2005.05.028

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…The optimal cutoff for PP was 60 mm Hg, which is consistent with the cutoff suggested in previous studies. 7,8,17,18 The VAT-free survival curve according to PP is illustrated in Figure 2. Patients with a PP460 mm Hg were more at risk for VAT than were patients with a PPo60 mm Hg (Po0.001, log-rank test).…”

Section: Resultsmentioning

confidence: 99%

The association between pulse pressure and vascular access thrombosis in chronic hemodialysis patients

et al. 2009

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Vascular access thrombosis (VAT) is a major cause of morbidity in chronic hemodialysis (HD) patients and is characterized by chronic inflammation. Pulse pressure (PP) is positively associated with chronic inflammation. Whether patients with high PP are at a higher risk for VAT, however, remains unknown. We retrospectively reviewed chronic HD patients with a functional vascular access point at the China Medical University Hospital between 1986 and 2005. The association between PP and the initial development of VAT at the primary vascular access point was examined using the Kaplan-Meier analysis and multivariate Cox proportional hazards regression. A total of 576 chronic HD patients (264 men and 312 women) with a mean age of 56.9 ± 14.0 years were reviewed, of whom 145 (25.2%) experienced at least one episode of VAT. Patients with a PP460 mm Hg had a lower VAT-free survival rate compared with those with a PPo60 mm Hg (Po0.001). Using Cox regression with adjustments for age, systolic blood pressure and vascular access types, PP (every increase of 10 mm Hg) and serum C-reactive protein (CRP) (every increase of 1 mg per 100 ml) were found to be independently associated with an increasing risk for VAT, with a hazard ratio of 2.57 (95% confidence interval: 1.5-4.4, P¼0.001) and 1.14 (95% confidence interval: 1.01-1.27, P¼0.017), respectively. High PP was associated with the development of VAT in chronic HD patients. This association was independent of serum CRP levels.

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Section: Resultsmentioning

confidence: 99%

The association between pulse pressure and vascular access thrombosis in chronic hemodialysis patients

et al. 2009

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“…Tozawa et al (14) pointed out that the power of pulse pressure to predict total mortality was more accurate than that of SBP or DBP alone. London et al (12) described the importance of pulse pressure in considering BP control, and several studies reported that pulse pressure was an independent risk factor for CVE in the general population (25)(26)(27)(28)(29) and an independent predictor of risk for mortality or CVE in longterm HD patients (13)(14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, several studies have reported the relationship between pulse pressure and mortality or cardiovascular events in HD patients (13)(14)(15)(16)(17). In this study, we studied in a prospective cohort whether WAB was a more useful prognostic marker in HD patients than one-point BP measurement and investigated which components of WAB were the most potent marker in evaluating the effect of hypertension on cardiovascular events (CVE) or all-cause mortality in HD patients.…”

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confidence: 99%

Weekly Averaged Blood Pressure Is More Important than a Single-Point Blood Pressure Measurement in the Risk Stratification of Dialysis Patients

Moriya

Oka

Maesato

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: With regard to monitoring blood pressure in hemodialysis patients, it is important to define clearly the time point at which the blood pressure is measured, because the blood pressure of hemodialysis patients varies with each hemodialysis session as a result of loss of excess fluid.Design, setting, participants, & measurements: Using weekly averaged blood pressure, 96 hemodialysis patients were studied prospectively for 35 mo. All patients were followed up for cardiovascular events or death from all causes.Results: Pulse weekly averaged blood pressure and age at enrollment were significantly higher and parathyroid hormone level was significantly lower in patients with cardiovascular events compared with those without cardiovascular events; however, none of the components of pre-or postdialysis blood pressure was significantly different between patients with and without cardiovascular events. Pulse weekly averaged blood pressure, prepulse pressure, age, and human atrial natriuretic peptide were significantly higher in patients who died than in survivors. Kaplan-Meier method with a log-rank test demonstrated that survival free rate from cardiovascular events and that of all-cause mortality in patients with pulse weekly averaged blood pressure >70 mmHg were significantly lower than those in the remaining patients.Conclusions: One-point measurement of blood pressure is insufficient to evaluate hypertension and prognosis of hemodialysis patients, and weekly averaged blood pressure is a useful marker because of averaging fluctuations of blood pressure during 1 wk. Among components of weekly averaged blood pressure, pulse weekly averaged blood pressure could be a good prognostic marker of the incidence of both cardiovascular events and all-cause mortality in hemodialysis patients.

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“…PP is influenced by the compliance of the aorta as well as stroke volume. High PP increases risk of cardiovascular events in an older population (Blacher et al, 2000;Fernández-Escribano Hernández et al, 2007;Foucan et al, 2005).…”

Section: Methodsmentioning

confidence: 99%

Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility

Giese‐Davis

Conrad

Nouriani

et al. 2008

Personality and Individual Differences

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We examined relationships between three emotion-regulation constructs and autonomic physiology in metastatic breast cancer patients (N = 31). Autonomic measures are not often studied in breast cancer patients and may provide evidence of an increase in allostatic load. Patients included participated as part of a larger clinical trial of supportive-expressive group therapy. Systolic and diastolic blood pressure and heart rate were assessed at a semi-annual follow-up. We averaged 3 resting assessments and used measures of Repression, Suppression, Restraint of Hostility, and Body Mass Index as predictors of autonomic response. We found that higher repression was significantly associated with higher diastolic blood pressure, while higher restraint of hostility was significantly associated with higher systolic blood pressure. A repressive emotion regulation style may be a risk factor for higher sympathetic activation possibly increasing allostatic load, while restraint of hostility may be a protective factor for women with metastatic breast cancer.Keywords emotion regulation; emotional expression; autonomic physiology; breast cancer; repression; suppression; hostility Studies have demonstrated that diminished emotional expressiveness is associated with health risks. For example, research has linked repression (low anxiety and high defensiveness) and suppression (deliberate withholding of the expression of negative emotions) with faster cancer progression and shorter survival (Bahnson, 1981;Fox, Harper, Hyner, & Lyle, 1994; GieseDavis & Spiegel, 2003;Greer, 1985;Greer & Morris, 1975;Gross, 1989;Kneier & Temoshok, 1984). In addition, an epidemiological study found that subjects likely to suppress anger were at greater mortality risk from all causes across age, sex, and education groups (Julius, E., Cottington, & Johnson, 1986). In the Julius study, suppressed anger significantly interacted with elevated blood pressure (BP) to predict the highest mortality risk (Julius et al., 1986). Three emotion inhibition processes may be associated with psychological and physiological indices of health in metastatic breast cancer patients: suppression, repression, and restraint of Corresponding Author: Janine Giese-Davis, Ph.D., 401 Quarry Rd., Rm 2318, Stanford, CA 94305-5718. (Phone) 650-498-5160. (Fax) 650-725-3762. jgiese@stanford.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Repression is a defense mechanism in which a person is unable to remember or be cognitively aware of disturbing wishes, feelings, thoughts, or experiences ((Task Force on DSM-IV, 1994), pp. 756-757). ...

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High Pulse Pressure Associated With Cardiovascular Events in Patients With Type 2 Diabetes Undergoing Hemodialysis

Abstract: Our results suggest that the strongest association of PP with CV morbidities should be considered in therapeutic strategies. These results show the necessity of targeting antihypertensive treatment to patients' predialysis blood pressure values.

Cited by 14 publications

References 21 publications

The association between pulse pressure and vascular access thrombosis in chronic hemodialysis patients

The association between pulse pressure and vascular access thrombosis in chronic hemodialysis patients

Weekly Averaged Blood Pressure Is More Important than a Single-Point Blood Pressure Measurement in the Risk Stratification of Dialysis Patients

Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility

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