Abstract
Stroke is one of the most dreaded complications of left ventricular assist device therapy in patients with end-stage congestive heart failure. There is strong evidence linking anticoagulation and infection with ischemic and hemorrhagic strokes, though recent data has emerged regarding the importance of elevated blood pressure. In the recently completed Heartware Ventricular Assist Device studies, a mean arterial pressure greater than 90 mmHg was associated with greater stroke risk, particularly the hemorrhagic subtype. In this review, we discuss recent evidence regarding deleterious effects of uncontrolled hypertension in patients with left ventricular devices, and propose measurement and management strategies.
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Dr. Willey is a consultant for Heartware and is on the Clinical Endpoint Committee for Reliant Heart. Drs. Boehme, Castagna, Yuzefpolskaya, Garan, Topkara, and Colombo declare no conflicts of interest.
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This article is part of the Topical Collection on Blood Pressure Monitoring and Management
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Willey, J.Z., Boehme, A.K., Castagna, F. et al. Hypertension and Stroke in Patients with Left Ventricular Assist Devices (LVADs). Curr Hypertens Rep 18, 12 (2016). https://doi.org/10.1007/s11906-015-0618-1
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DOI: https://doi.org/10.1007/s11906-015-0618-1