Impact of Low Diastolic Blood Pressure on Risk of Cardiovascular Death in Elderly Patients With Coronary Artery Disease After Revascularization　– The CREDO-Kyoto Registry Cohort-1 –

• Kai Hisashi

  Department of Cardiology, Kurume University Medical Center

• Kimura Takeshi

  Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University

• Fukuda Kenji

  Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine Department of Cerebrovascular Medicine, St. Mary’s Hospital

• Fukumoto Yoshihiro

  Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine

• Kakuma Tatsuyuki

  Biostatisctics Center, Kurume University

• Furukawa Yutaka

  Division of Cardiology, Kobe City Medical Center General Hospital

• on behalf of CREDO-Kyoto Investigators

Abstract

Background:We investigated the effects of age and low diastolic blood pressure (DBP) on cardiovascular death in patients with coronary artery disease (CAD) after coronary revascularization.Methods and Results:Stable, chronic CAD patients after coronary revascularization in the CREDO-Kyoto registry cohort-1 were allocated to the Young (≤64 years, n=2,619), Young-Old (65–74 years, n=2,932), and Old-Old (≥75 years, n=1,629) groups. Kaplan-Meier analysis showed that the crude cumulative incidence of cardiovascular death was higher in Young-Old patients with DBP <70 mmHg (P<0.001) and in Old-Old patients with DBP <60 mmHg (P=0.017), but not <70 mmHg (P=0.629), compared with each counterpart. Low DBP did not increase cardiovascular death in young patients. After adjustments with independent predictors, DBP <60 mmHg did not increase the cardiovascular death in the Old-Old group (HR=1.579 [95% CI, 0.944–2.642], P=0.082) and DBP <70 mmHg remained a predictor in the Young-Old group (HR=1.665 [1.094–2.532], P=0.017). On multivariate stepwise Cox proportional hazard regression analysis, independent predictors for cardiovascular death in low DBP patients were creatinine clearance (CCr; inversely), prior cerebrovascular disease, and aortic disease in the Young-Old group and CCr (inversely) and malignancy in the Old-Old group.Conclusions:DBP <60 mmHg was not an independent factor for predicting cardiovascular death in Old-Old revascularized CAD patients, whereas DBP <70 mmHg remained a predictor in the Young-Old. (Circ J 2016; 80: 1232–1241)

Journal

• Circulation Journal

  Circulation Journal 80 (5), 1232-1241, 2016

  The Japanese Circulation Society

Keywords

• Blood pressure
• Cardiovascular risks
• Coronary artery disease
• Elderly
• J-shaped curve phenomenon

Details

• CRID: 1390282680084016384
• NII Article ID: 130005147673
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-15-1151
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 027270056
• PubMed: 27053493
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I027270056
• Web Site: https://www.jstage.jst.go.jp/article/circj/80/5/80_CJ-15-1151/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2017010415
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed