{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:03:42Z","timestamp":1777421022778,"version":"3.51.4"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Hypertension is a predominant risk factor for aortic dissection (AD), and blood pressure (BP) control plays a vital role in the management of AD. However, the correlation between BP change and the prognosis for AD remains unclear. This study aims to demonstrate the impact of BP change patterns on AD prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included AD patients at two institutions (Shanghai Ninth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine and the Vascular Department of the First Affiliated Hospital of Anhui Medical University) between 2004 and 2018. The systolic BP (SBP) change patterns of these patients were analyzed by functional data analysis (FDA). The relationship between BP change patterns and the risk of adverse events (AEs) was assessed using survival analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 458 patients with AD were eligible for analysis. The logistic regression analysis indicated that compared with that in patients with low SBP variation (SBPV), the incidence of AEs in patients with high SBPV was significantly higher (35.84 vs. 20.35%, OR 2.19, <jats:italic>P<\/jats:italic> &amp;lt; 0.001). The patients were divided into four categories (accelerating rise, accelerating drop, decelerating rise, and decelerating drop) based on their SBP patterns after FDA fitting. The results of Kaplan\u2013Meier analysis showed that at the 15- and 20-min time points, the incidence of AEs in the decelerating-drop group was significantly lower than that in the accelerating-rise group (OR 0.19, <jats:italic>P<\/jats:italic> = 0.031 and OR 0.23, <jats:italic>P<\/jats:italic> = 0.050). However, at the 25- and 30-min time points, the difference between these four groups was not significant (OR 0.26, <jats:italic>P<\/jats:italic> = 0.08 and OR 0.29, <jats:italic>P<\/jats:italic> = 0.10).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study classified AD patients into four groups according to the SBP change patterns the first 30 min following admission, of which those with accelerating rises in SBP are at the highest risk of AEs, while those with decelerating drops have the best prognosis in the first 24 h after admission. Clinical practitioners may benefit from analyzing patterns of in-hospital SBP.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.832770","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T08:57:59Z","timestamp":1654246679000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic Impact of Blood Pressure Change Patterns on Patients With Aortic Dissection After Admission"],"prefix":"10.3389","volume":"9","author":[{"given":"Zhaoyu","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haichun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weimin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruihua","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinwu","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1161\/CIRCULATIONAHA.117.031264","article-title":"Insights from the international registry of acute aortic dissection: a 20-year experience of collaborative clinical research","volume":"137","author":"Evangelista","year":"2018","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2611","DOI":"10.1161\/CIRCULATIONAHA.106.630400","article-title":"Thoracic aortic aneurysm and dissection: increasing prevalence and improved outcomes reported in a nationwide population-based study of more than 14,000 cases from 1987 to 2002","volume":"114","author":"Olsson","year":"2006","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1111\/j.1524-6175.2005.04116.x","article-title":"Aortic dissection","volume":"7","author":"Prisant","year":"2005","journal-title":"J Clin Hypertens (Greenwich)."},{"key":"B4","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1001\/jama.283.7.897","article-title":"The international registry of acute aortic dissection (irad): new insights into an old disease","volume":"283","author":"Hagan","year":"2000","journal-title":"JAMA."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1016\/j.jacc.2018.01.064","article-title":"presenting systolic blood pressure and outcomes in patients with acute aortic dissection","volume":"71","author":"Bossone","year":"2018","journal-title":"J Am Coll Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/s0003-4975(10)66476-4","article-title":"Treatment of dissecting aneurysms of the aorta","volume":"4","author":"Palmer","year":"1967","journal-title":"Ann Thorac Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. 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