Impact of the Management of Type B Aortic Dissection on the Long-Term Blood Pressure

Delsart, Pascal; Ledieu, Guillaume; Ramdane, Nassima; Sobocinski, Jonathan; Clough, Rachel E.; Azzaoui, Richard; Mounier‐Véhier, Claire; Nienaber, Christoph; Haulon, Stéphan

doi:10.1016/j.amjcard.2017.04.052

Cited by 18 publications

(6 citation statements)

References 25 publications

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“…Controlled SBP/DBP <130/80 mmHg has also been reported to reduce the risk of recurrence of aortic dissection in patients with type B dissection. 25 In the present study, the abnormal SBP/DBP cut-off for the primary prevention of AAD-related death was 130/82 mmHg. This equaled the target value of BP-lowering therapy in cardiovascular disease.…”

Section: Abnormal Cut-off For Aad-related Deathmentioning

confidence: 48%

Effect of Hypertension on Aortic Artery Disease-Related Mortality　― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Otaki

Watanabe

Konta

et al. 2018

Circ J

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The prevalence of hypertension (HT) is still increasing and is a well-known risk for cardiovascular disease and mortality. The mechanisms by which HT is involved in the development of cardiovascular disease includes several complex processes such as the sympathetic nervous system, renin-angiotensin-aldosterone system (RAAS), and oxidative stress. 5 Several guidelines, such as the Japanese Society of Hypertension (JSH) 2014, recommend lowering blood pressure (BP) to <140 and <90 mmHg for the primary A ortic artery disease (AAD), namely aortic artery dissection or aortic aneurysm rupture, is a major cause of sudden death. 1,2 In almost all cases of aortic aneurysm rupture, the patient dies before arriving at hospital; furthermore, the mortality rate ≤24 h after symptom onset reaches approximately 50-70% despite surgical treatment. 3 Similarly, the mortality rates in those with ascending aortic dissection between 24 h and 1 month after onset are 20% and 50%, respectively. 4 Therefore, it is critical to identify high-risk subjects and prevent the development of AAD in apparently healthy subjects using health checkups .

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Section: Abnormal Cut-off For Aad-related Deathmentioning

confidence: 48%

Effect of Hypertension on Aortic Artery Disease-Related Mortality　― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Otaki

Watanabe

Konta

et al. 2018

Circ J

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“…39 Meanwhile, higher systolic blood pressure readings at night have prognostic significance and are associated with an increased risk of aortic events during follow-up in those with TBAD. 40 Low levels of antihypertensive medication adherence in TBAD may therefore play a part in contributing to the high levels of aortic morbidity and mortality seen in this cohort of patients, particularly in those being managed medically. This is the first study to specifically look at rates of antihypertensive medication adherence in the cohort of TBAD patients.…”

Section: Discussionmentioning

confidence: 97%

Antihypertensive medication adherence in chronic type B aortic dissection is an important consideration in the management debate

Martin

Patel

Grant

et al. 2018

Journal of Vascular Surgery

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Medical management remains the mainstay of treatment in uncomplicated TBAD; however, the majority of patients are poorly adherent to their antihypertensive medications. The merits of thoracic endovascular aortic repair in TBAD are argued, and poor adherence is an important factor in the debate; one cannot robustly compare two strategies when half of a treatment group may not be receiving the stated intervention. To develop an evidence-based treatment strategy for TBAD, we must take into account the direct and indirect effects of medical therapy and thoracic endovascular aortic repair. Further work to improve medication adherence and to understand its impact on disease progression is vital to inform the debate and to deliver the best outcomes for patients.

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“…The prevalence of high DBP (≥80 mmHg) was relatively high, and persistent high DBP may be a feasible marker for AD-related death in the general Japanese population aged sive BP control relative to conventional BP control in type B aortic dissection is in progress, 25 it was reported that a controlled BP of <130/80 mmHg reduced the risk of recurrence of aortic dissection in patients with type B aortic dissection. 26 Kobeissi et al demonstrated that the risk of abdominal aortic aneurysm significantly increases at a DBP of 79 mmHg. 11 Considering these studies, we defined high DBP as DBP ≥80 mmHg and assessed the change in DBP in an apparently healthy Japanese population aged 50-75 years.…”

Section: Discussionmentioning

confidence: 99%

One-Year Change in Diastolic Blood Pressure and Aortic Disease-Related Mortality in a Japanese General Population Aged 50–75 Years

Otaki

Watanabe

Konta

et al. 2021

Circ J

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have systemic HT, although there is a lower prevalence of HT among young patients aged <40 years with AD who are more likely to have genetic alterations. 8,9 HT is also associated with the presence and development of aortic aneurysms. 10,11 Therefore, the management of HT is of clinical interest in the primary prevention of AD in adults. Recent research focusing on systolic blood pressure (SBP)lowering therapy since landmark trials in the 1990 s showed the benefits of SBP-lowering therapy on cardiovascular disease in isolated systolic HT in the elderly. 12,13 In contrast, diastolic blood pressure (DBP) is gaining attention in the field of AD. We have previously reported that both SBP and DBP are associated with AD-related deaths in the A ortic disease (AD) comprises a spectrum of potentially devastating conditions, including aortic dissection, aortic aneurysm, and aortic rupture. 1 Despite remarkable diagnostic and therapeutic progress over the past several decades, mortality and morbidity in patients with AD remain high. 1-6 Therefore, it is critical to identify high-risk patients and prevent the development of AD in apparently otherwise healthy individuals during health check-ups.The prevalence of hypertension (HT) is still increasing, and HT is a well-known risk factor for cardiovascular disease, as well as AD. 5,7 According to the International Registry of Aortic Dissection data, the majority of patients

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Impact of the Management of Type B Aortic Dissection on the Long-Term Blood Pressure

Abstract: Ambulatory blood pressure (BP) measurement (ABPM) is recommended to assess optimal BP control, we studied its influence after an acute type B aortic dissection (ATBAD).We retrospectively collected data from 111 patients with ATBAD from January 2004 to

Cited by 18 publications

References 25 publications

Effect of Hypertension on Aortic Artery Disease-Related Mortality　― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Effect of Hypertension on Aortic Artery Disease-Related Mortality　― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Antihypertensive medication adherence in chronic type B aortic dissection is an important consideration in the management debate

One-Year Change in Diastolic Blood Pressure and Aortic Disease-Related Mortality in a Japanese General Population Aged 50–75 Years

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Impact of the Management of Type B Aortic Dissection on the Long-Term Blood Pressure

Abstract: Ambulatory blood pressure (BP) measurement (ABPM) is recommended to assess optimal BP control, we studied its influence after an acute type B aortic dissection (ATBAD).We retrospectively collected data from 111 patients with ATBAD from January 2004 to

Cited by 18 publications

References 25 publications

Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Effect of Hypertension on Aortic Artery Disease-Related Mortality ― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Antihypertensive medication adherence in chronic type B aortic dissection is an important consideration in the management debate

One-Year Change in Diastolic Blood Pressure and Aortic Disease-Related Mortality in a Japanese General Population Aged 50–75 Years

Contact Info

Product

Resources

About

Effect of Hypertension on Aortic Artery Disease-Related Mortality　― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―

Effect of Hypertension on Aortic Artery Disease-Related Mortality　― 3.8-Year Nationwide Community-Based Prospective Cohort Study ―