In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to EAPC Ivory (& above) Members, Fellows of the ESC and Young combined Members

In patients with coronary artery disease systolic blood pressure peaks at age 80 years and diastolic blood pressure starts to decrease at less than 60 years.

Session Poster Session 3

Speaker Hartmut Seyfert

Congress : EuroPrevent 2019

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease - Other
  • Session type : Poster Session
  • FP Number : P711

Authors : H Seyfert (Demmin,DE)

Authors:
H Seyfert1 , 1Kreiskrankenhaus Demmin - Department of Cardiology - Demmin - Germany - Germany ,

Citation:

Introduction

Few data exist on blood pressure in the old and very old. As a substantial part of patients (Pts) with symptomatic coronary artery disease (CAD) is older than 80 years, knowledge of age-dependance of blood pressure (BP) in these patients is mandatory to prevent inadvertent consequences.

Method

Between 2002 and 2016, in 6344 patients Pts presenting the first time in our institution with indication for percutaneous coronary intervention (PCI - 3691 Pts with acute myocardial infarction (MI)). BP was measured at the beginning of PCI with the pigtail catheter in the coronary sinus. 10 BP cycles were averaged for determining systolic (RRs), diastolic (RRd), mean (RRm) BP, and BP amplitude (RR-Amp). 69.2% Pts were male, median age was 68 yrs (95% CI 64,7 – 65,4; IQR 58 – 76 yrs). Coronary artery disease was classified as 1-, 2- or 3-vessel disease (VD), if a diameter stenosis > 50% of a major epicardial coronary artery was present in 1, 2 or 3 coronary arteries, respectively. Left main disease was was not additionally categorized. 1-VD was found in 32,5%, 2-VD in 31,3%, and 3-VD in 36,2% of Pts. Arterial hypertension was found in 79,2%, diabetes in 34,5%, dyslipidaemia in 79%, smoking in 27,6%, obesity in 33,4%, family history of cardiovascular disease in 14%, cerebrovascular disease in 7,4%, peripheral arterial occlusive disease in 3,3% Pts. 10,4% had a history of MI, 6,2% CABG, 10,8% prior PCI, and on dialysis were 1,3%.

Results

BP increased from < 40 years to it's peak at 80 years (p < 0,001, ANOVA – Log-Transformation) with a slight decrease thereafter, whereas diastolic BP decreased from age 60 continuously (p < 0,001, ANOVA – Log-Transf.). Consequently RR-Amp as sign of arterial stiffness increased to it's peak at 90 years (p < 0,001, ANOVA – Log-Transf.), whereas RRm showed only a moderate decrease (p < 0,001, ANOVA – Log-Transf.).

Conclusion

In Pts with symptomatic CAD and indication for coronary intervention systolic BP reaches it's peak at 80 years with a decline thereafter, accompanied by a decrease of diastolic BP which starts earlier in life. As a consequence coronary perfusion pressure decreases, as it is mainly driven by diastolic blood pressure. Additionally, decreasing systolic as well as diastolic BP might cause renal or cerebral malperfusion. Careful BP therapy is mandatory in old and very old Pts with symptomatic CAD to maintain or improve quality of life and to prevent symptoms caused by therapeutic interventions.

The free consultation period for this content is over.

It is now only available year-round to EAPC Ivory (& above) Members, Fellows of the ESC and Young combined Members



Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are