Blood pressure control according to clinical practice guidelines is associated with decreased mortality and cardiovascular events among liver transplant recipients
Open accessAbstract
Data for liver transplant recipients (LTRs) regarding the benefit of care concordant with clinical practice guidelines for management of blood pressure (BP) are sparse. This paper reports on clinician adherence with BP clinical practice guideline recommendations and whether BP control is associated with mortality and cardiovascular events (CVEs) among LTRs. We conducted a longitudinal cohort study of adult LTRs who survived to hospital discharge at a large tertiary care network between 2010 and 2016. The primary exposure was a BP of <140/<90 mm Hg within year 1 of LT. Among 602 LTRs (mean age 56.7 years, 64% men), 92% had hypertension and 38% had new onset hypertension. Less than 30% of LTRs achieved a BP of <140/<90 mm Hg over a mean of 43.2 months. In multivariable models, adjusted for key confounders, BP control post-LT compared with lack of control was associated with a significantly lower hazard of mortality (hazard ratio [HR] 0.48, 95% confidence interval [CI] 0.39, 0.87) and of CVEs (HR 0.65, 95% CI 0.43, 0.97). The association between BP control of <140/<90 mm Hg with improved survival and decreased CVEs in LTRs suggests that efforts to improve clinician adherence to BP clinical practice recommendations should be intensified.
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Optimal blood pressure control is associated with a 42% relative reduction in all-cause mortality and a 35% reduction in cardiovascular events, stroke in particular.
“Optimal blood pressure control is associated with a 42% relative reduction in all-cause mortality and a 35% reduction in cardiovascular events, stroke in particular. 520”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [520]
The Results report a 42% lower adjusted hazard of all-cause mortality and a 35% lower adjusted hazard of cardiovascular events among liver transplant recipients with blood pressure controlled to <140/<90 mmHg. The Results also identify stroke as the most common cardiovascular event, but do not establish a 35% reduction in stroke specifically. The Discussion says the optimal blood-pressure target remains to be determined. (LLM, conf=0.88)
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- Authors
- VanWagner, L. B., Holl, J. L., Montag, S., Gregory, D., Connolly, S., Kosirog, M., Campbell, P., Pine, S., Daud, A., Finn, D., Ladner, D., Skaro, A. I., Levitsky, J., & Lloyd-Jones, D. M.
- Affiliations
- Northwestern University (US)
- University of Chicago (US)
- Western University (CA)
- Corresponding author
- VanWagner, Lisa B.
- ORCID
- Venue
- American Journal of Transplantation
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 20
- Issue
- 3
- Pages
- 797-807
- ISSN
- 1600-6135 (ISSN-L)
- PMC
- PMC7042060
- OpenAlex
- W2986328223
- Cited by
- 55
- References
- 30
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 12 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 7 · 2019: 1
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Transplantation (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Advancing Translational Sciences (UL1TR001422)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- liver transplant recipients, blood pressure control, hypertension, clinical practice guideline adherence, mortality, cardiovascular events, antihypertensive therapy, post-transplant care
- MeSH terms
- Adult, Blood Pressure, Cardiovascular Diseases, Female, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Liver Transplantation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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