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The presentation and management of hypertension in a large cohort of Takayasu arteritis

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Abstract

The objective of this study was to explore the presentation and management of hypertension secondary to Takayasu arteritis (TA) in a large cohort, single center in China. We retrospectively analyzed 381 TA patients with hypertension hospitalized in Fuwai hospital between Jan. 2004 and Feb. 2014. Diagnosis of hypertension was according to clinic blood pressure or the central blood pressure measured during angiography. Renal artery stenosis was the most common cause (264, 69.3%), followed by the thoracic descending aorta stenosis (98, 25.7%), abdominal aorta stenosis (78, 20.5%), and severe aortic regurgitation (45, 11.8%). More than two kinds of pathologies were found in 98 (25.7%) patients. The mean age of hypertension onset was 25.0 ± 14.3 years. The mean blood pressure of upper extremity in patients without bilateral subclavian artery stenosis (321, 84.3%) was 176.0 ± 29.4 mmHg/97.2 ± 23.0 mmHg, while in 60 (15.7%) patients with bilateral subclavian artery stenosis, the mean central blood pressure was 192.7 ± 30.8 mmHg/102.4 ± 121.1 mmHg. A total of 305 were followed for 38.4 ± 36.7 months, and the rate of blood pressure control, improvement, and failure was 50.8, 41.0, and 8.2%, respectively. Immunosuppressive therapy (OR 2.402, 95% confidence interval 1.253–4.603, P = 0.008) and the pathogenesis of hypertension (P = 0.010) were associated with prognosis of hypertension. The pathogenesis of hypertension due to TA is very complex and multifactorial. Renal artery stenosis is most frequently observed, followed by stenosis of the thoracic descending aorta, abdominal aorta, and severe aortic regurgitation. Immunosuppressive therapy and identifying the pathogenesis of hypertension is of great importance in patients with TA.

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Author notes

  1. Yu Qi and Lirui Yang both contributed equally to this work

Authors and Affiliations

  1. Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing City, 100037, People’s Republic of China

    Yu Qi, Huimin Zhang, Erpeng Liang, Lei Song, Jun Cai, Xiongjing Jiang, Yubao Zou, Haiyan Qian, Haiying Wu, Xianliang Zhou, Rutai Hui & Deyu Zheng

  2. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing City, 100029, People’s Republic of China

    Lirui Yang

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  1. Yu Qi
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Correspondence to Huimin Zhang or Jun Cai.

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The study protocol was approved by the Institutional Ethics Committee of Fuwai Hospital (No. 2016-842).

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Qi, Y., Yang, L., Zhang, H. et al. The presentation and management of hypertension in a large cohort of Takayasu arteritis. Clin Rheumatol 37, 2781–2788 (2018). https://doi.org/10.1007/s10067-017-3947-4

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  • DOI: https://doi.org/10.1007/s10067-017-3947-4

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