Blood Pressure最新文献

{"title":"Attended vs. unattended blood pressure - learnings beyond SPRINT.","authors":"Sverre E Kjeldsen, Guido Grassi, Reinhold Kreutz, Giuseppe Mancia","doi":"10.1080/08037051.2021.1995981","DOIUrl":"https://doi.org/10.1080/08037051.2021.1995981","url":null,"abstract":"Blood pressure (BP) has been measured as office BP, usually taken after 5 minutes of quiet rest, in all clinical outcome trials in hypertension until recently, when the Systolic Blood Pressure Intervention Trial (SPRINT) was carried out. In the publication of the main SPRINT results it was not evident how BP had been measured (1). Following some literature search (2) it became visible that BP in SPRINT was taken as unattended automated office blood pressure (unattendedAOBP). The more than 100 sites participating in the SPRINT Study in the U.S.A. used the Omron 907 automated device. Personal were additionally trained to use the full capacity of this device by leaving the room prior to the 5 minutes period of rest followed by the preset unattended automated measurements at 5, 6 and 7 minutes. This is properly described in later publications including the article reporting the subgroup data in the elderly participants (3). However, a post hoc investigation in response to the debate suggested that not all investigators had followed the protocol and left the room prior to BP measurement (3). Alternatively, some of the SPRINT investigators years later may in fact not remember how their personal had performed the BP measurement.","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39573998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulty and importance of diagnosing stenosis of renal branch artery in fibromuscular dysplasia: a case report.","authors":"Andreas Skræddergaard,&nbsp;Jakob Nyvad,&nbsp;Kent Lodberg Christensen,&nbsp;Arne Hørlyck,&nbsp;Hossein Mohit Mafi,&nbsp;Mark Reinhard","doi":"10.1080/08037051.2021.1993735","DOIUrl":"https://doi.org/10.1080/08037051.2021.1993735","url":null,"abstract":"<p><p>A 16-year-old patient presented with abdominal pain and sustained hypertension. Thorough evaluation including renography with and without captopril and renal vein renin sampling were normal. Duplex ultrasound, however, raised suspicion of a renal artery stenosis. This was confirmed by computed tomography angiography which showed a severe branch artery stenosis with post-stenotic dilatation consistent with focal fibromuscular dysplasia (FMD). As the hypertension was resistant to 3 classes of antihypertensive treatment, percutaneous transluminal renal angioplasty (PTRA) was offered. The procedure had immediate effect on the blood pressure. Without medication the patient remains normotensive 4 years after and the abdominal pain has only sporadically returned. The presented case illustrates the challenging process of diagnosing FMD-related renal branch artery stenosis as well as the potential benefits of PTRA in this patient group.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39557815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unattended automated office blood pressure measurement in children.","authors":"Tomáš Seeman,&nbsp;Kryštof Staněk,&nbsp;Jakub Slížek,&nbsp;Jan Filipovský,&nbsp;Janusz Feber","doi":"10.1080/08037051.2021.1963666","DOIUrl":"https://doi.org/10.1080/08037051.2021.1963666","url":null,"abstract":"<p><strong>Purpose: </strong>We studied the performance of unattended automated office blood pressure (uAOBP) measurement in children, in relation to oscillometric office BP (OBP) and ambulatory blood pressure monitoring (ABPM).</p><p><strong>Materials and methods: </strong>One hundred and eleven stable treated and untreated outpatients investigated for hypertension underwent uAOBP measurements (seated unattended in a quiet room separate from the renal clinic room, six times after a 5 min rest with the BpTRU device), and immediately before using the oscillometric device. Ambulatory 24 h blood pressure monitoring (ABPM) was performed on the same day in a subgroup of 42 children.</p><p><strong>Results: </strong>UAOBP measurements were successful in 106 children (95%), 5 pre-school children did not tolerate to be alone in the room. The mean ± SD systolic/diastolic uAOBP, OBP and daytime ABP were 109.1 ± 14.0/70.8 ± 10.7 mmHg, 121.6 ± 16.5/77.6 ± 10.5 mmHg and 123.5 ± 11.3/73.7 ± 6.8 mmHg, respectively. Systolic/diastolic uAOBP was significantly lower than OBP by 13.6/7.6 mmHg (<i>p</i> < 0.0001) and lower than daytime ABP by 14.4 ± 0.5/2.9 ± 0.3 mmHg (<i>p</i> < 0.0001). The heart rate was not significantly different during uAOBP than during OBP measurements. On Bland Altman analysis the uAOBP underestimated OBP by a mean of 15.6 mmHg for systolic BP and by 8.6 mmHg for diastolic BP. In all 9 children with white-coat systolic hypertension uAOBP was within the normal range (<95th pc for OBP), in six of nine children with white-coat diastolic hypertension uAOBP was within the normal range however, in three of them it was elevated despite normal ABP.</p><p><strong>Conclusion: </strong>uAOBP measurement is feasible in school-aged children, its values are considerably lower than OBP as well as daytime ABP and it could help with detection of white-coat systolic hypertension. The clinical applicability of uAOBP in children should be confirmed in further studies.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10664529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unattended automated office blood pressure in living donor kidney transplant recipients.","authors":"Minh Ngoc Nguyen,&nbsp;Karin Skov,&nbsp;Birgitte Bang Pedersen,&nbsp;Niels Henrik Buus","doi":"10.1080/08037051.2021.1991778","DOIUrl":"https://doi.org/10.1080/08037051.2021.1991778","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertension is common in kidney transplant recipients (KTRs). For the evaluation of blood pressure (BP), 24-h ambulatory BP measurements (ABPM) are considered superior to usual office measurements but are also resource demanding and troublesome to many patients. We therefore evaluated the use of unattended automated office BP (AOBP) during the first year following living donor kidney transplantation and compared AOBP with ABPM as obtained 12 months after transplantation.</p><p><strong>Materials and methods: </strong>Data were retrieved from a cohort of 57 KTRs (mean age 45 ± 14 years, 75% males) who all received kidneys from living donors and had a good graft function (estimated glomerular filtration rate (eGFR) 52 ± 16 ml/min/1.73 m² at 12 months). Unattended AOBP was measured at each visit to the outpatient clinic using the BpTru® device, while ABPM was obtained by Spacelabs® equipment before and 12 months after transplantation.</p><p><strong>Results: </strong>AOBP remained stable from month 2 (130.2 ± 10.8/82.2 ± 7.8 mmHg) to month 12 (129.0 ± 12.8/83.1 ± 9.6 mmHg) post-transplantation. At 12 months follow-up, ambulatory daytime systolic BP was slightly higher than AOBP (132.7 ± 10.7 <i>vs.</i> 129.4 ± 12.2 mmHg, <i>p</i> = 0.04), while diastolic BP was similar (82.7 ± 7.7 <i>vs.</i> 82.0 ± 10.2 mmHg). Using Bland-Altman plots, 95% limits of agreements were -17.9 to 24.5 mmHg for systolic and -16.5 to 15.1 mmHg for diastolic BP. When considering a target BP of ≤130/<80 mmHg, 62% had sustained hypertension, 9% white coat hypertension and 11% masked hypertension. Using multiple linear regression analysis, only urine albumin-creatinine ratio tended to predict a higher systolic AOBP (<i>p</i> = 0.07).</p><p><strong>Conclusion: </strong>In a cohort of stable living donor KTRs, mean values of unattended AOBP using BpTru® are comparable to daytime ABPM with a misclassification rate of approximately 20%.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39531272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of a strategy combining ambulatory blood pressure, adherence monitoring and a standardised triple therapy in resistant hypertension.","authors":"Erietta Polychronopoulou,&nbsp;Michel Burnier,&nbsp;Georg Ehret,&nbsp;Renate Schoenenberger-Berzins,&nbsp;Maxime Berney,&nbsp;Belen Ponte,&nbsp;Paul Erne,&nbsp;Murielle Bochud,&nbsp;Antoinette Pechère-Bertschi,&nbsp;Gregoire Wuerzner","doi":"10.1080/08037051.2021.1907174","DOIUrl":"https://doi.org/10.1080/08037051.2021.1907174","url":null,"abstract":"<p><strong>Purpose: </strong>Poor adherence to drug therapy and inadequate drug regimens are two frequent factors responsible for the poor blood pressure (BP) control observed in patients with apparent resistant hypertension. We evaluated the efficacy of an antihypertensive management strategy combining a standardised therapy with three long acting drugs and electronic monitoring of drug adherence in patients with apparent resistant hypertension.</p><p><strong>Materials and methods: </strong>In this multicentric observational study, adult patients with residual hypertension on 24 h ambulatory BP monitoring (ABMP) despite the use of three or more antihypertensive drugs could be included. Olmesartan/amlodipine (40/10 mg, single pill fixed-dose combination) and chlorthalidone (25 mg) were prescribed for 3 months in two separated electronic pills boxes (EPB). The primary outcome was 24 h ambulatory systolic BP (SBP) control at 3 months, defined as mean SBP <130 mmHg.</p><p><strong>Results: </strong>We enrolled 48 patients (36.0% women) of whom 35 had complete EPB data. After 3 months, 52.1% of patients had 24 h SBP <130 mmHg. 24 h SBP decreased by respectively -9.1 ± 15.5 mmHg, -22.8 ± 30.6 mmHg and -27.7 ± 16.6 mmHg from the tertile with the lowest adherence to the tertile with the highest adherence to the single pill combination (<i>p</i> = 0.024). A similar trend was observed with tertiles of adherence to chlorthalidone. Adherence superior to 90% was associated with 24 h systolic and diastolic blood pressure control in multiple logistic regression analysis (odds ratio = 14.1 (95% confidence interval 1.1-173.3, <i>p</i> = 0.039).</p><p><strong>Conclusions: </strong>A simplified standardised antihypertensive therapy combined with electronic monitoring of adherence normalises SBP in about half of patients with apparent resistant hypertension. Such combined management strategy enables identifying patients who need complementary investigations and those who rather need a long-term support of their adherence.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1907174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39154566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The five RADIANCE-HTN and SPYRAL-HTN randomised studies suggest that the BP lowering effect of RDN corresponds to the effect of one antihypertensive drug.","authors":"Sverre E Kjeldsen,&nbsp;Krzysztof Narkiewicz,&nbsp;Michel Burnier,&nbsp;Suzanne Oparil","doi":"10.1080/08037051.2021.1995975","DOIUrl":"https://doi.org/10.1080/08037051.2021.1995975","url":null,"abstract":"Renal denervation (RDN) may be a new treatment modality for patients with hypertension. Initially, efforts to test the efficacy of RDN in lowering blood pressure (BP) have focussed on patients with apparent treatment resistant hypertension (aTRH). The SYMPLICITY HTN2 trial [1] reported a major reduction in systolic BP with RDN in patients with aTRH using office-based BP measurement. However, using ambulatory BP, the state-ofthe art technique for measuring BP in patients with aTRH [2], BP reductions were less evident [1]. Further, since poor drug adherence, which is common in aTRH [3], was not monitored in SYMPLICITY HTN-2, interpretation of the study results could be confounded by the Hawthorne effect i.e. patients started taking their drugs as prescribed in response to the attention devoted to them [4]. SYMPLICITY HTN-3 [5] included a sham control group and ambulatory BP measurements that balanced the Hawthorne and white-coat, placebo, and regressionto-the–mean effects, resulting in a BP reduction of 2mmHg in the RDN treatment group compared to the sham control. Further, meta-analyses of the first generation of randomised controlled studies of RDN did not show BP lowering effects of RDN (Figures 1 and 2), whether or not SYMPLICITY HTN-3 was included [6], and whether or not a sham control (Figures 3 and 4) was a part of the design [7]. However, these disappointments [5–7] did not end the interest in RDN for many reasons. First, total abdominal sympathectomy resulting from surgical splanchnicectomy was highly effective in the treatment of severe hypertension in cohorts of patients reported in the 1930s [8] and 1950s [9,10]. Second, the meta-analyses showed that RDN did not lead to severe adverse events and could be considered safe [6,7]. Third, the role of the sympathetic nervous system in the pathophysiology of hypertension is strong [11,12]. Further, the procedural problems that contributed to the failure of early RDN trials to lower BP could be overcome [13,14]. Therefore, new protocols were designed to assess the antihypertensive efficacy of RDN. One new approach was to perform clinical studies in untreated hypertensive","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39573756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum uric acid change in relation to antihypertensive therapy with the dihydropyridine calcium channel blockers.","authors":"Di Zhang,&nbsp;Qi-Fang Huang,&nbsp;Chang-Sheng Sheng,&nbsp;Yan Li,&nbsp;Ji-Guang Wang","doi":"10.1080/08037051.2021.1996220","DOIUrl":"https://doi.org/10.1080/08037051.2021.1996220","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated serum uric acid changes in relation to the achieved clinic and ambulatory blood pressure after 8 weeks of antihypertensive therapy with two dihydropyridine calcium channel blockers.</p><p><strong>Materials and methods: </strong>The study participants were patients with clinic and ambulatory hypertension, enrolled in a randomised controlled trial that compared amlodipine (5-10 mg, <i>n</i> = 215) and nifedipine gastrointestinal therapeutic system (GITS, 30-60 mg, <i>n</i> = 203). Hyperuricaemia was defined as a serum uric acid concentration of ≥420 µmol/L in men and ≥360 µmol/L in women. Analysis of covariance and multiple regression analyses were performed to study the associations between serum uric acid changes and the achieved clinic and ambulatory blood pressure during follow-up.</p><p><strong>Results: </strong>At baseline, 67 (16.0%) of the 418 patients had hyperuricaemia. Antihypertensive treatment reduced clinic and 24-h daytime and night-time systolic/diastolic blood pressure by a mean (±standard error [SE]) change of -17.4 ± 0.6/-8.6 ± 0.4 mm Hg and -13.7 ± 0.5/-8.3 ± 0.3 mm Hg, -13.8 ± 0.6/-8.4 ± 0.4 mm Hg, and -12.7 ± 0.7/-8.0 ± 0.4 mm Hg, respectively. Antihypertensive treatment reduced serum uric acid by a mean (±SE) change of -9.3 ± 2.8 μmol/L. The serum uric acid changes differed according to the achieved clinic and ambulatory blood pressure, and were statistically significant (mean ± SE -20.6 ± 6.6 to -10.7 ± 2.9 μmol/L, <i>p</i> ≤ 0.04) at the systolic/diastolic ranges of 130-139/≥90 mm Hg in clinic pressure, and <130/75-84 mm Hg, <145/80-84 mm Hg and <120/65-69 mm Hg in 24-h, daytime and night-time ambulatory pressure.</p><p><strong>Conclusion: </strong>Our study showed that antihypertensive therapy with a dihydropyridine calcium channel blocker was associated with reduced serum uric acid, especially when 24-h ambulatory systolic blood pressure was controlled.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39573762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension telemonitoring and home-based physical training programs.","authors":"Olívia Moraes Ruberti,&nbsp;Juan Carlos Yugar-Toledo,&nbsp;Heitor Moreno,&nbsp;Bruno Rodrigues","doi":"10.1080/08037051.2021.1996221","DOIUrl":"https://doi.org/10.1080/08037051.2021.1996221","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertensive patients with access to telemedicine can receive telemonitoring of blood pressure and cardiovascular risk factors such as sedentary lifestyle, diet, and remote supervision of treatment compliance. Faced with this challenge, electronic devices for telemonitoring of BP have gained space. They have shown to be effective in the follow-up of hypertensive patients and assist in the adherence and control of associated risk factors such as physical inactivity and obesity.</p><p><strong>Materials and methods: </strong>Narrative Review.</p><p><strong>Results: </strong>The use of advanced smartwatches, smartphone apps, and online software for monitoring physical activity is increasingly common. Electronic equipment is briefly presented here as a support for better addressing some cardiovascular variables. Using various automated feedback services with a follow-up multidisciplinary clinical team is the ideal strategy.</p><p><strong>Conclusion: </strong>Mobile health can improve risk factors and health status, particularly for hypertensive patients, improving access to cardiac rehabilitation and reducing the cost.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39826339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistant hypertension after renal infarction in a man with fibromuscular dysplasia.","authors":"Nikolina Bukal,&nbsp;Dražen Pekov,&nbsp;Luka Penezić,&nbsp;Bojan Jelaković,&nbsp;Živka Dika","doi":"10.1080/08037051.2021.2003180","DOIUrl":"https://doi.org/10.1080/08037051.2021.2003180","url":null,"abstract":"<p><p>We report the case of 39-year-old Caucasian man presenting in emergency department with new onset of severe hypertension with hypokalaemia eight weeks after renal colic. Patient was referred to a hypertension unit for further investigation. Hormonal analysis confirmed secondary aldosteronism and slightly impaired kidney function. Imaging revealed smaller right kidney, 'string of beads appearance' of distal part of right renal artery, a short zone of dissection and renal infarction. Renal scintigraphy showed significant blood flow reduction and severe functional damage of the right kidney. Despite multidrug antihypertensive treatment patient's hypertension was resistant and target organ damage evolved. After initial patient's refusal, he was later successfully treated with laparoscopic simple nephrectomy. Histopathological analysis confirmed renal artery dissection and medial fibroplasia. Thereafter, hypertension was controlled with trandalopril monotherapy. This is a first case report of the patient with renovascular multifocal fibromuscular dysplasia, dissection and renal infarction whose diagnosis of the disease was confirmed by angiography and histopathologic analysis. Resistant hypertension was successfully treated with nephrectomy.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative hypotension and its organ-related consequences in hypertensive subjects undergoing abdominal surgery: a cohort study.","authors":"Szymon Czajka,&nbsp;Zbigniew Putowski,&nbsp;Łukasz J Krzych","doi":"10.1080/08037051.2021.1947777","DOIUrl":"https://doi.org/10.1080/08037051.2021.1947777","url":null,"abstract":"<p><p><b>Purpose</b>. Intraoperative hypotension is associated with organ hypoperfusion, which is deleterious to vital organs. Little is known about the prevalence and consequences of intraoperative hypotension in subjects with arterial hypertension (AH). The primary goal of this study was to investigate the prevalence and determinants of hypoperfusion-related clinical consequences of intraoperative hypotension, taking into account the role of AH, in a homogeneous cohort of patients undergoing abdominal surgery.<b>Materials and methods.</b> We enrolled 508 patients (219 males, median age 62 years). Intraoperative hypotension was defined as systolic blood pressure (SBP) <90 mmHg for at least 10 min or mean arterial pressure (MAP) <65 mmHg for at least 10 min or a need for noradrenaline infusion of at least 0.05 μg/kg/min for ≥10 min or intraoperative MAP drop of at least 30% from the baseline value for at least 10 min, regardless of the time of surgery. Acute kidney injury, stroke or transient ischaemic attack, delirium, and myocardial infarction were considered as the outcome.<b>Results.</b> AH concerned 234 (46%) individuals. The prevalence of intraoperative hypotension varied from 19.9 to 59.4%. Patients with AH were more likely to experience MAP drop of >30% than non-hypertensive patients (OR = 1.53; 95%CI 1.07-2.19; <i>p</i> = 0.02). The outcome was diagnosed in 38 (7.5%) patients. AH was a significant predictor of hypoperfusion-related events, regardless of the intraoperative hypotension definition applied (logOR 2.80 ÷ 3.22; <i>p</i> < 0.05 for all). Only intraoperative hypotension defined as 'MAP < 65mmHg' was found to be a determinant of negative outcome (logOR = 2.85; 95%CI 1.35-5.98; <i>p</i> < 0.01), with AUROC = 0.83 (95%CI 0.0-0.86); <i>p</i> < 0.01.<b>Conclusion</b>. AH is a significant predictor of hypoperfusion-related events, regardless of the intraoperative hypotension definition applied. In hypertensive patients, hypoperfusion-related clinical consequences are more frequent in high-risk and long-lasting procedures. MAP < 65 mmHg lasting for >10 min during surgery was identified as most associated with the negative outcome.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39256824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}