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Aortic atherosclerosis is a key modulator of the prognostic value of postural blood pressure changes.

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eMediNexus Editorial    16 March 2018

Orthostatic blood pressure decrease or increase has been linked to cardiovascular events in hypertensive patients.

A new study published in Atherosclerosis aimed to ascertain the role of aortic atherosclerosis (ATS) in large variations of blood pressure after orthostatic stress.

This study investigated the interaction of ATS on the prognostic value of postural blood pressure changes in a cohort of 958 hypertensive patients with an aortography. These patients had a mean blood pressure of 182/110 mmHg, and 61% of the patients included were males.

A follow up was conducted after 15 years; the results revealed 280 all-cause and 167 cardiovascular deaths. Systolic blood pressure (SBP) changes could be statistically correlated to all-cause and cardiovascular mortality only in the presence of ATS. Moreover, risk associated with the magnitude of SBP changes was more pronounced than that associated with its direction.

From the findings, it was inferred that the prognostic significance of postural SBP changes is markedly influenced by ATS in hypertensive patients.

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