Key result
Higher post-6MWT diastolic blood pressure links to ~51% lower 6-month death or rehospitalization in AHF.
Why the study?
It remained unclear whether systolic and diastolic blood pressure and blood pressure response after the six-minute walk test were associated with adverse outcomes in patients with acute heart failure.
Does higher blood pressure after a 6-minute walk test predict lower risk of adverse outcomes in patients with acute heart failure?
Cohort (n=98)
Does higher blood pressure after a 6-minute walk test predict lower risk of adverse outcomes in patients with acute heart failure?
Higher blood pressure levels and ratios immediately after a 6-minute walk test are associated with a lower risk of death or rehospitalization at 6 months in patients with acute heart failure.
Association with lower risk should not change acute HF management; leaves open need for prospective validation of post-6MWT BP.
BACKGROUND: It remains unclear whether systolic (SBP) and diastolic (DBP) pressure and BP response after six-minute walk test (6MWT) are associated with adverse outcomes in patients with acute heart failure (AHF). METHODS: We investigated these associations in 98 AHF patients (24.5% women; mean age, 70.5 years) enrolled in the ROSE trial (The Low-dose Dopamine or Low-dose Nesiritide in Acute Heart Failure with Renal Dysfunction). The primary endpoint consisted of any death or rehospitalization within 6 months after randomization. We computed hazard ratios (HRs) of the risks associated with 1-SD increase in post-exercise BP levels and BP ratios, calculated as BP immediately after 6MWT divided by BP before 6MWT. RESULTS: The BP before and after 6MWT averaged 110.6/117.5 mm Hg for SBP and 61.9/64.7 mm Hg for DBP. In multivariable-adjusted analyses including clinic BP measured at the same day of 6MWT, higher DBP after 6MWT was associated with lower risk of the primary endpoint (HR, 0.49; 95% confidence interval [CI], 0.26-0.95; P = 0.034). Both higher SBP and DBP immediately after 6MWT were associated with lower risk of 6-month mortality (HRs, 0.39/0.16; 95% CI, 0.17-0.90/0.065-0.40; P ≤ 0.026). The post-exercise SBP ratio was associated with the risk of 6-month mortality in multivariable-adjusted analyses (HR, 0.44; P = 0.023). CONCLUSIONS: Higher BP levels and BP ratios immediately after 6MWT conferred lower risk of adverse health outcomes. Our observations highlight that 6MWT-related BP level and response may refine risk estimates in patients hospitalized AHF and may help further investigation for the development of HF preventive strategies.
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Huang et al. (2023) conducted a cohort in Acute heart failure (n=98). Six-minute walk test (6MWT) post-exercise blood pressure was evaluated on Any death or rehospitalization within 6 months after randomization (HR 0.49, 95% CI 0.26-0.95, p=0.034). Higher diastolic blood pressure after a six-minute walk test was associated with a lower risk of 6-month death or rehospitalization in acute heart failure (HR 0.49; 95% CI 0.26-0.95; P=0.034).
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