Journal of cardiology · 2015
Prognostic impact of preexisting hypertension and high systolic blood pressure at admission in patients hospitalized for systolic heart failure.
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Lee Ji Hyun, Lee Jun-Won, Youn Young-Jin, Ahn Min Soo, Ahn Sung Gyun, Kim Jang Young, Lee Seung-Hwan, Yoon Junghan, Oh Jaewon, Kang Seok-Min, Jeon Eun-Seok, Choi Dong-Ju, Ryu Kyu-Hyung, Yoo Byung-Su
Аннотация
BACKGROUND: Higher systolic blood pressure (SBP) has been reported to be associated with a better prognosis in heart failure (HF) patients. This study aimed to investigate the prognostic impact of hypertension in patients hospitalized with systolic HF.
METHODS: Pooled analysis of data from three Korean observational studies was performed. Patients ≥18 years hospitalized with systolic HF (ejection fraction ≤45%) (n=3538) were compared for the incidence of 1-year all-cause mortality according to the presence of preexisting hypertension and SBP quartiles on admission.
RESULTS: Patients with hypertension (prevalence, 51.6%) presented more often with diabetes (43.9% vs. 23.0%, p<0.001) and chronic kidney disease (14.1% vs. 5.7%, p<0.001). During the 1-year follow-up, patients with hypertension showed similar cumulative incidences of all-cause mortality as those without hypertension (8.3% vs. 8.4%, p=0.900). Conversely, patients with higher SBP on admission had a lower incidence of all-cause death (quartile 4 vs. 1: 6.7% vs. 11.3%, p for trend=0.004). In the multivariate analysis, an increase in SBP of 10 mmHg was associated with an 8.5% risk reduction of all-cause death (hazard ratio: 0.915, 95% confidence interval: 0.853-0.981, p=0.013).
CONCLUSIONS: Higher SBP on admission was independently associated with a lower risk of 1-year all-cause mortality in systolic HF.
METHODS: Pooled analysis of data from three Korean observational studies was performed. Patients ≥18 years hospitalized with systolic HF (ejection fraction ≤45%) (n=3538) were compared for the incidence of 1-year all-cause mortality according to the presence of preexisting hypertension and SBP quartiles on admission.
RESULTS: Patients with hypertension (prevalence, 51.6%) presented more often with diabetes (43.9% vs. 23.0%, p<0.001) and chronic kidney disease (14.1% vs. 5.7%, p<0.001). During the 1-year follow-up, patients with hypertension showed similar cumulative incidences of all-cause mortality as those without hypertension (8.3% vs. 8.4%, p=0.900). Conversely, patients with higher SBP on admission had a lower incidence of all-cause death (quartile 4 vs. 1: 6.7% vs. 11.3%, p for trend=0.004). In the multivariate analysis, an increase in SBP of 10 mmHg was associated with an 8.5% risk reduction of all-cause death (hazard ratio: 0.915, 95% confidence interval: 0.853-0.981, p=0.013).
CONCLUSIONS: Higher SBP on admission was independently associated with a lower risk of 1-year all-cause mortality in systolic HF.