Predictors of poor blood pressure control assessed by 24 hour monitoring in patients with type B acute aortic dissection

Pascal Delsart¹, Marco Midulla², Jonathan Sobocinski³, Charles Achere⁴, Stephan Haulon³, Gonzague Claisse¹, Claire Mounier-Vehier^1
1Vascular Medicine and Hypertension Department, Cardiology Hospital, CHRU Lille, ²Radiology and Cardiovascular Imaging Department, Cardiology Hospital, CHRU Lille, ³Vascular Surgery Department, Cardiology Hospital, CHRU Lille, ⁴Cardiology Department, Cardiology Hospital, CHRU Lille, France

Abstract: The chronic management of post-acute aortic dissection (AD) of the descending aorta (Type B) is based on optimal control of blood pressure (BP), with a target BP < 135/80 mmHg. The aim of our study was to determine and verify effective blood pressure control with an objective measurement method and to identify predicting factors.
Methods: We collected data from 26 patients hospitalized in the acute phase of a Type B AD between 2006 and 2009. Two groups were defined according to 24 hour BP monitoring results at follow-up. Group 1 consisted of patients with a controlled BP (< 130/80 mmHg), and Group 2 consisted of patients with an uncontrolled BP.
Results: Thirty four percent of patients showed an uncontrolled BP at checkup. Vascular history before AD (P = 0.06), high baseline BP trend (P = 0.01 for systolic and P = 0.08 for diastolic), and greater diameter of the descending aorta (P = 0.02) were associated with poor BP control.
Conclusion: Prognosis after AD is associated with BP control. Therefore, 24 hour BP monitoring can be made.

Keywords: acute aortic syndrome, blood pressure monitoring, hypertension