In patients with heart failure, home and ambulatory systolic BP showed U-shaped associations with elevated NT-proBNP (inflection points 126.6 and 114.0 mmHg) and predicted concentric hypertrophy.
Observational (n=902)
Is out-of-office blood pressure associated with elevated NT-proBNP and left ventricular remodeling in patients with heart failure?
Out-of-office blood pressure shows a significant U-shaped association with elevated NT-proBNP and is an independent risk factor for concentric hypertrophy in heart failure patients, with stronger associations than office blood pressure.
Objective: Evidence on the clinical value of out-of-office blood pressure (BP) monitoring in patients with heart failure (HF) remains limited. The relationships between out-of-office BP levels and HF severity as well as left ventricular (LV) remodeling are not fully established. Design and method: A total of 902 HF patients from the Out-of-Office Blood Pressure Measurements in Patients with Heart Failure Registry Study (OOBPM-HF study) were included. Univariable and multivariable logistic regression models were used to evaluate the associations of office BP and out-of-office BP with elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP). Restricted cubic spline (RCS) models were applied to explore potential non-linear associations between BP indices and the risk of elevated NT-proBNP. In addition, multivariable logistic regression models were used to assess the associations between office/out-of-office BP and LV remodeling. Results: Twenty-four-hour ambulatory systolic BP (SBP), nighttime ambulatory SBP, evening home SBP, home diastolic BP (DBP), and nighttime ambulatory DBP were independently and inversely associated with elevated NT-proBNP. RCS analyses demonstrated significant U-shaped associations between office SBP, home SBP, and ambulatory SBP and the risk of elevated NT-proBNP, with corresponding inflection points of 137.9 mmHg, 126.6 mmHg, and 114.0 mmHg, respectively. Office SBP, home SBP, 24-hour ambulatory SBP, and 24-hour ambulatory DBP were independent risk factors for concentric hypertrophy in HF patients, and the associations of out-of-office SBP with concentric hypertrophy were stronger than those of office SBP. Conclusions: In patients with HF, both office SBP and out-of-office SBP show significant U-shaped associations with the risk of elevated NT-proBNP. Office SBP, out-of-office SBP, and 24-hour ambulatory DBP are independent risk factors for concentric hypertrophy.
Miao et al. (Fri,) conducted a observational in Heart failure (n=902). Out-of-office blood pressure was evaluated on Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) and left ventricular remodeling. In patients with heart failure, home and ambulatory systolic BP showed U-shaped associations with elevated NT-proBNP (inflection points 126.6 and 114.0 mmHg) and predicted concentric hypertrophy.