Key result
A 1-SD higher admission systolic blood pressure was associated with a higher risk of long-term mortality in Chinese patients with heart failure (HR 1.11; 95% CI 1.02-1.22; P=0.017).
Why the study?
It was unknown whether admission SBP and DBP are associated with short- and long-term mortality in Chinese patients with HFpEF, HFmrEF, and HFrEF.
Are admission systolic and diastolic blood pressures associated with short- and long-term mortality in Chinese patients with different heart failure subtypes?
Cohort (n=2,706)
Are admission systolic and diastolic blood pressures associated with short- and long-term mortality in Chinese patients with different heart failure subtypes?
Lower admission diastolic blood pressure and higher systolic blood pressure are associated with increased risk of all-cause mortality across different heart failure subtypes, suggesting admission BP is a useful risk stratification tool.
Answers are grounded in this paper and cite their sources.
Admission BP associates with mortality across HF subtypes; hypothesis-generating and should not yet change practice.
It remains unknown whether systolic (SBP) and diastolic (DBP) pressure on admission are associated with short- and long-term mortality in Chinese patients with heart failure with preserved (HFpEF), mildly reduced (HFmrEF), and reduced (HFrEF) ejection fraction. In 2706 HF patients (39.1% women; mean age, 68.8 years), we assessed the risk of 30-day, 1-year, and long-term (> 1 year) mortality with 1-SD increment in SBP and DBP, using multivariable logistic and Cox regression, respectively. During a median follow-up of 4.1 years, 1341 patients died. The 30-day, 1-year, and long-term mortality were 3.5%, 16.7%, and 39.4%, respectively. In multivariable-adjusted analyses additionally accounted for DBP or SBP, a higher SBP conferred a higher risk of long-term mortality (hazard ratio, 1.11; 95% CI, 1.02-1.22; p = .017) and a lower DBP was associated with a higher risk of all types of mortality (p ≤ .011) in all HF patients. Independent of potential confounders including DBP or SBP, in patients with HFpEF, higher SBP and lower DBP levels predicted a higher risk of long-term mortality with hazard ratios amounting to 1.16 (95% CI, 1.04-1.29; p = .007) and .89 (95% CI, .80-.99; p = .028), respectively. In patients with HFmrEF and HFrEF, irrespective of adjustments of potential confounders, DBP was associated with 1-year mortality with odds ratios ranging from .49 to .62 (p ≤ .006). In conclusion, lower DBP and higher SBP levels on admission were associated with a higher risk of different types of all-cause mortality in Chinese patients with different HF subtypes. Our observations highlight that admission BP may help to improve risk stratification.
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Chen et al. (2022) conducted a cohort in Heart failure (n=2,706). Admission systolic blood pressure (1-SD increment) was evaluated on Long-term mortality (HR 1.11, 95% CI 1.02-1.22, p=0.017). A 1-SD higher admission systolic blood pressure was associated with a higher risk of long-term mortality in Chinese patients with heart failure (HR 1.11; 95% CI 1.02-1.22; P=0.017).
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