Does intensive blood pressure control benefit type B aortic dissection patients who undergoing surgical repair?

• Published in: Perfusion 2023-09, Vol.38 (6), p.1260-1267
• Main Authors: Qian, Sichong, Ding, Xiaohang, Liu, Hong, He, Xiaohui, Wang, Shipan, Du, Ying, Zhang, Hongjia, Li, Haiyang
• Format: Article
• Language: English
• Subjects: Angiotensin; Antihypertensives; Aorta; Aortic dissection; Blood pressure; Dissection; Diuretics; Enzyme inhibitors; Hypertension; Mortality; Patients; Peptidyl-dipeptidase A; Surgery
• ISSN: 0267-6591; 1477-111X
• DOI: 10.1177/02676591221110425

Objectives The aim of this research is to determine the optimum blood pressure (BP) control goal for hypertensive type B aortic dissection (TBAD) patients undergoing surgery. Methods Between January 2019 and April 2021, 259 hypertensive TBAD patients undergoing surgery were included in the research. 98 patients received intensive BP control with a target of systolic BP (SBP) < 120 mmHg, and 161 received standard BP control targeting SBP between 120 and 140 mmHg. Clinical data from two groups were compared. Results Patients who received intensive BP control experienced a significantly higher incidence of acute kidney injury (AKI) postoperatively (21/98, 21.4% vs 14/161, 8.7%, p = 0.004). The intensive group took more anti-hypertensive drugs per day compared with the standard group (1.9 vs 1.5, p < 0.001). Triple-drug combination treatment was more frequent in the intensive group (38.8% vs 14.3%, p < 0.001), as were angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB; 67.3% vs 44.7%, p 0.001), and thiazide-like diuretic (44.9% vs 18.0%, p < 0.001). Conclusions Intensive BP control treatment increases the incidence of AKI and raises the utilization of the anti-hypertensive drug, but did not reduce the operative mortality and late mortality in TBAD patients undergoing surgical repair.