{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:04:28Z","timestamp":1793426668359,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Current guidelines recommend aggressive management of hypertension. Recent evidence suggested potential harm with low blood pressure targets in patients with peripheral artery disease. We investigated the association of a history of hypertension and office systolic blood pressure (SBP) with major adverse cardiovascular events (MACEs) and major adverse limb events (MALEs).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              The EUCLID trial (Examining the Use of Ticagrelor in Peripheral Artery Disease) included 13 885 participants with symptomatic peripheral artery disease; median follow-up was 30 months. Cox proportional hazards regression was used to calculate hazard ratios (HRs) for any MACE, MALE, and MALE including lower extremity revascularization. A clinical history of arterial hypertension was present in 10 857 (78%) participants, and these participants were older and more likely to be female when compared with the 3026 (22%) patients without hypertension. In patients with a history of hypertension, the adjusted hazard ratio for MACE was 0.94, 95% CI, 0.82\u20131.08;\n              <jats:italic>P<\/jats:italic>\n              =0.39, and the adjusted hazard ratio for MALE was 1.08, 95% CI, 0.96\u20131.23;\n              <jats:italic>P<\/jats:italic>\n              =0.21. During follow-up, average SBP was 135 mm Hg (125\u2013145). Every 10 mmHg increase in SBP&gt;125 mmHg was associated with an increased risk of MACE (HR, 1.10 [95% CI, 1.06\u20131.14];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), a marginally increased risk of MALE (HR, 1.07 [95% CI, 1.00\u20131.15];\n              <jats:italic>P<\/jats:italic>\n              =0.062), and an increased risk of MALE\/lower extremity revascularization (HR, 1.08 [95% CI, 1.04\u20131.11];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Every decrease in 10 mmHg SBP \u2264125 mmHg was associated with an increased risk of MACE (HR, 1.19 [95% CI, 1.09\u20131.31];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) but not MALE or MALE\/lower extremity revascularization (HR, 1.02 [95% CI, 0.84\u20131.23],\n              <jats:italic>P<\/jats:italic>\n              =0.824; HR, 1.04 [95% CI, 0.95\u20131.13],\n              <jats:italic>P<\/jats:italic>\n              =0.392, respectively).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>History of hypertension was not associated with higher hazard for MACE or MALE in patients with peripheral artery disease. In contrast, there was a higher hazard of MACE in patients with out-of-target low and high SBP. High but not low SBP was associated with an increased risk of ischemic limb events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01732822.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.120.006512","type":"journal-article","created":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T09:00:31Z","timestamp":1598864431000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Association of Hypertension and Arterial Blood Pressure on Limb and Cardiovascular Outcomes in Symptomatic Peripheral Artery Disease"],"prefix":"10.1161","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct01732822","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Marat","family":"Fudim","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, NC (M.F., Z.H., F.W.R., M.R.P., W.S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles W.","family":"Hopley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Nephrology and Hypertension, Geisel School of Medicine at Dartmouth College, Hanover, NH (C.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Huang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, NC (M.F., Z.H., F.W.R., M.R.P., W.S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Kavanagh","sequence":"additional","affiliation":[{"name":"CPC Clinical Research, Aurora, CO (S.K., C.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3732-4765","authenticated-orcid":true,"given":"Frank W.","family":"Rockhold","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, NC (M.F., Z.H., F.W.R., M.R.P., W.S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Swiss Cardiovascular Center, University of Bern, Switzerland (I.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"Berger","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Surgery, New York University School of Medicine (J.S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juuso I.","family":"Blomster","sequence":"additional","affiliation":[{"name":"University of Turku, Finland (J.I.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Gerry R.","family":"Fowkes","sequence":"additional","affiliation":[{"name":"University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, United Kingdom (F.G.R.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian G.","family":"Katona","sequence":"additional","affiliation":[{"name":"AstraZeneca, Gaithersburg, MD (B.G.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth W.","family":"Mahaffey","sequence":"additional","affiliation":[{"name":"Stanford Center for Clinical Research, Stanford University School of Medicine, CA (K.W.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Norgren","sequence":"additional","affiliation":[{"name":"Orebro University, Faculty of Medicine and Health, Sweden (L.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Ostrom","sequence":"additional","affiliation":[{"name":"CPC Clinical Research, Aurora, CO (S.K., C.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manesh R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, NC (M.F., Z.H., F.W.R., M.R.P., W.S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Schuyler","family":"Jones","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, NC (M.F., Z.H., F.W.R., M.R.P., W.S.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-7557","authenticated-orcid":true,"given":"William R.","family":"Hiatt","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Colorado School of Medicine, Division of Cardiology, and CPC Clinical Research, Aurora (W.R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.11.1197"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.01.053"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2015.07.002"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000066"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036409"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033348"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611688"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.01.018"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1989.10478874"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2307\/2533573"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000049640.46039.52"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2003.10.033"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178713"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h4865"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.142240"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.11.1317"}],"container-title":["Circulation: Cardiovascular Quality and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.120.006512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:47:39Z","timestamp":1715572059000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.120.006512"}},"subtitle":["The EUCLID Trial"],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.120.006512"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.120.006512","relation":{},"ISSN":["1941-7713","1941-7705"],"issn-type":[{"value":"1941-7713","type":"print"},{"value":"1941-7705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]},"assertion":[{"value":"2020-01-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006512"}}