Pulmonary wedge pressure predicts outcome in uncomplicated hypertension

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Last Updated: 2001-07-16 12:29:59 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – Mean pulmonary wedge pressure, as an indicator of left ventricular diastolic function, is a "significant and independent" predictor of cardiovascular events and death in patients with uncomplicated hypertension.

Drs. Robert Fagard and Karel Pardaens, of the University of Leuven KU Leuven in Belgium, report the finding in the June issue of the American Journal of Hypertension. While impaired left ventricular systolic function is known to be associated with a worse outcome in patients with uncomplicated hypertension, the prognostic value of diastolic function in these patients is less clear, the investigators note.

In a retrospective study, Drs. Fagard and Pardaens determined the outcome of 172 hypertensive patients who underwent invasive hemodynamic studies between 1972 and 1982. All of the subjects were free of cardiovascular disease at baseline.

During 2675 patient-years of follow-up, 15 patients died and 34 experienced at least one cardiac event. After controlling for age and gender, the investigators found that pulmonary wedge pressure was a significant predictor of total mortality and of cardiovascular events on Cox regression analysis.

"Each 1 mm Hg increase in wedge pressure was associated with a 23% increase in the risk of all-cause mortality and a 13% increase in the risk of a cardiovascular event," they write.

"The prognostic power was independent of mean brachial artery pressure, body mass index, serum cholesterol, electrocardiographic left ventricular hypertrophy, and smoking at baseline," they add.

Although further study is needed, Drs. Fagard and Pardaens conclude, based on their findings, that preventing or halting the progression of diastolic dysfunction "may be a worthwhile goal to pursue in the treatment of hypertension."

Am J Hypertens 2001;14:504-508.

-Westport Newsroom 203 319 2700

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