Key result
Out-of-office systolic BP shows a U-shaped link to elevated NT-proBNP and concentric hypertrophy in HF.
Why the study?
Evidence on the clinical value of out-of-office BP monitoring in HF remains limited, and relationships between out-of-office BP levels, HF severity, and LV remodeling are not fully established.
Is out-of-office blood pressure associated with elevated NT-proBNP and left ventricular remodeling in patients with heart failure?
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.
Answers are grounded in this paper and cite their sources.
May warrant incorporating out-of-office BP into HF evaluation; leaves open whether U-shaped targets improve outcomes.
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.
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Miao et al. (2026) conducted an 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.
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