Higher systolic (HR 0.89 per 10 mmHg) and diastolic (HR 0.80) blood pressures were associated with lower 2-year mortality in tricuspid regurgitation, while higher resting heart rate increased risk.
Cohort (n=2,013)
Are blood pressure and resting heart rate associated with all-cause mortality in patients with moderate or severe tricuspid regurgitation?
In patients with moderate or severe tricuspid regurgitation, lower blood pressure and higher resting heart rate are independently associated with increased 2-year all-cause mortality.
Effect estimate: HR 0.89 per 10 mmHg SBP, HR 0.8 per 10 mmHg DBP, HR 1.1 per 10 bpm RHR (95% CI 0.823-0.957 (SBP), 0.714-0.908 (DBP), 1.022-1.175 (RHR))
p-value: p=0.002 (SBP), <0.001 (DBP), 0.011 (RHR)
Background The prognostic value of blood pressure (BP) and resting heart rate (RHR) in tricuspid regurgitation (TR) patients is unknown. Aims This study aimed to investigate the associations of BP and RHR with all-cause mortality in patients with TR. Methods A total of 2,013 patients with moderate or severe TR underwent echocardiography and BP measurement. The associations of routinely measured BP and RHR with 2-year all-cause mortality were analyzed. Results The cohort had 45.9% male patients and a mean age of 62.5 ± 15.9 years. At the 2-year follow-up, 165 patient deaths had occurred. The risk of death decreased rapidly, negatively correlating with systolic blood pressure (SBP) up to 120 mmHg and diastolic blood pressure (DBP) up to 70 mmHg. For RHR, the risk increased in direct proportion, starting at 80 beats per min. After adjusting for age, sex, body mass index (BMI), diabetes, coronary heart disease, pulmonary hypertension, estimated glomerular filtration rate (eGFR), and NYHA class, SBP hazard ratio (HR):0.89; 95% CI:0.823–0.957 per 10 mmHg increase; P =0.002, DBP (HR:0.8; 95% CI:0.714–0.908 per 10 mmHg increase; P 0.001), and RHR (HR: 1.1; 95% CI: 1.022–1.175 per 10 beats per min increase; P = 0.011) were independently associated with all-cause mortality. These associations persisted after further adjustments for echocardiographic indices, medications, serological tests, and etiologies. Conclusion In this cohort of patients with TR, routinely measured BP and RHR were associated with all-cause mortality independently. However, further large-scale, high-quality studies are required to validate our findings.
Guo et al. (Wed,) conducted a cohort in Moderate or severe tricuspid regurgitation (n=2,013). Blood pressure and resting heart rate was evaluated on 2-year all-cause mortality (HR 0.89 per 10 mmHg SBP, HR 0.8 per 10 mmHg DBP, HR 1.1 per 10 bpm RHR, 95% CI 0.823-0.957 (SBP), 0.714-0.908 (DBP), 1.022-1.175 (RHR), p=0.002 (SBP), <0.001 (DBP), 0.011 (RHR)). Higher systolic (HR 0.89 per 10 mmHg) and diastolic (HR 0.80) blood pressures were associated with lower 2-year mortality in tricuspid regurgitation, while higher resting heart rate increased risk.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: