SYSTOLIC BLOOD-PRESSURE AND (CARDIAC) MORTALITY OVER 15 YEARS AFTER VENOUS CORONARY-BYPASS SURGERY

Objective The aim of the present study was to determine the influence of pre-operative systolic blood pressure and systolic blood pressure 1 and 5 years after venous coronary bypass surgery on subsequent cardia c and non-cardiac mortality. Design A prospective 15 years follow-up s tudy. Patients A series of 446 consecutive coronary bypass surgery pat ients, operated on between April 1976 and April 1977. According to the ir systolic blood pressure, patients were divided into five groups. Ma in outcome measures Systolic blood pressure 5 years after surgery, but not pre-operative systolic blood pressure, was an independent predict or of cardiac mortality. Results Multivariate Cox proportional hazards analysis revealed that pre-operative systolic blood pressure was not associated with cardiac mortality, while higher systolic blood pressur e 1 year after surgery showed a trend towards increased cardiac mortal ity. Systolic blood pressure 5 years after surgery appeared to be a st rong independent predictor of cardiac mortality during the subsequent follow-up period. Patients with a systolic blood pressure of 130-139 m mHg had the lowest risk. Compared to this group, the cardiac mortality risk in patients with a systolic blood pressure 5 years after surgery of 140-149 mmHg, 150-159 mmHg and greater than or equal to 160 mmHg, was 2.3 (1.2 to 4.6), 3.4 (1.6 to 7.1) and 3.1 (1.4 to 6.5) times high er. Systolic blood pressure <130 mmHg 5 years after surgery was also a ssociated with a 2.3 times (1.1 to 4.7) times increased risk for cardi ac mortality? compared to patients with a systolic blood pressure of 1 30-139 mmHg. Conclusions These findings underline the importance of sy stolic blood pressure control in the initial years after coronary bypa ss surgery.