The lower the better? Optimal achieved blood pressure for patients with coronary artery disease undergoing percutaneous coronary interventions and kidney failure

Abstract

Abstract Background This study investigates the ideal achieved blood pressure (BP) in ethnic Chinese patients with coronary disease (CAD) and kidney failure (eGFR<15 ml/min/1.73m2). Methods A total of 575 kidney failure patients who had undergone percutaneous coronary interventions (PCI) were enrolled and divided into 6 to 4 groups according to blood pressure range were analyzed. The clinic outcomes included major cardiovascular events (MACE) and MACE plus hospitalization for congestive heart failure (Total CV event). Results The mean systolic BP was 135.02±24.73 mmHg and diastolic BP was 70.74±13.05 mmHg. Systolic BP 140–149mmHg and diastolic BP 80–89mmHg had lowest MACE/CV event incidence rate (11%/23%; 13.2%/21.1%) compare to other groups. Patients with systolic BP<120mmHg had a higher risk MACE (HR: 2.014; 95% CI: 1.172–3.462, p=0.008) when compared to those with systolic BP 140–149 mmHg. Patients with systolic BP≥160mmHg (HR: 1.838; 95% CI, 3.266–1.035, p=0.038). And diastolic blood BP ≥90mmHg (HR: 2.191; 95% CI: 1.147–4.188, p=0.018) had a higher risk of total cardiovascular events when compared to those with systolic BP 140–149 mmHg and diastolic BP 80–89 mmHg. Conclusions A J-shaped BP association of systolic (140–149 mmHg) and diastolic (80–89 mmHg) was found with decreased cardiovascular events for coronary artery disease with kidney failure after undergoing PCI in non-western population. Funding Acknowledgement Type of funding source: None