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Comparative Study
. 2009 Mar;23(3):182-7.
doi: 10.1038/jhh.2008.121. Epub 2008 Oct 2.

Peripheral arterial disease and isolated systolic hypertension: the ATTEST study

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Comparative Study

Peripheral arterial disease and isolated systolic hypertension: the ATTEST study

M E Safar et al. J Hum Hypertens. 2009 Mar.

Abstract

Hypertension is a risk factor for cardiovascular (CV) diseases, either coronary artery disease (CAD), peripheral artery disease (PAD) or cerebrovascular disease (CVD). The relationships between those different localizations of CV disease and the haemodynamic features of hypertension have been poorly evaluated in the past. In the ATTEST study, a geographically representative panel of 3020 general practitioners recruited 8316 consecutive patients with CV diseases (PAD, CAD or CVD, alone or in association). Blood pressure, which was not an inclusion criterion, was then measured and related to the different forms of CV diseases. Blood pressure classification involved 20% normotensive subjects, 24% subjects with controlled hypertension, 42% subjects with isolated systolic hypertension and 14% subjects with systolic-diastolic hypertension, all hypertensives with or without antihypertensive therapy. From multiple regression analysis, it appeared that subjects with systolic hypertension were characterized by the presence of PAD, with little or no presence of CAD and/or CVD. Subjects with systolic-diastolic hypertension were characterized by the presence of CAD and/or CVD, but without PAD. Although the former was only influenced by age, dyslipidaemia and diabetes mellitus influenced the latter. This study confirms the high prevalence of hypertension (80%) in a large population of patients with CV diseases selected in primary care. Analysis of different features of hypertension revealed that isolated systolic hypertension was the most prevalent form of hypertension in this treated population. Finally, one of the predominant goals of secondary prevention in subjects with PAD should be the treatment of isolated systolic hypertension.

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Comment in

  • Hypertension and peripheral arterial disease.
    Bennett PC, Silverman S, Gill P. Bennett PC, et al. J Hum Hypertens. 2009 Mar;23(3):213-5. doi: 10.1038/jhh.2008.126. Epub 2008 Oct 16. J Hum Hypertens. 2009. PMID: 18923435 No abstract available.

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