Key result
Pulse pressure of 55-60 mmHg is linked to ~121% higher CHF risk versus lower pressures.
Why the study?
Hypertension plays a pivotal role in heart failure, which is mostly non-ischemic in origin, yet few studies have examined the association of individual blood pressure parameters with heart failure.
Do specific blood pressure parameters, such as pulse pressure, predict the development of congestive heart failure in hypertensive patients?
Cross-Sectional (n=205)
No
Do specific blood pressure parameters, such as pulse pressure, predict the development of congestive heart failure in hypertensive patients?
Hazard Ratio: 2.21 (95% CI 1.16–4.21)
p-value: p=0.016
In hypertensive patients, an elevated pulse pressure of 55-60 mmHg is a significant prognosticator for the development of congestive heart failure, more than doubling the risk compared to lower pulse pressures.
Should not yet change hypertension management; hypothesis-generating for pulse pressure as heart failure predictor in observational cohorts.
Introduction: Global incidence of heart failure is on increase. Heart failure has been shown to be on the increase with 1-3% admission rates globally and a 3-7% admission rate in the African hospitals. Hypertension (HTN) has been shown to play a pivotal role in the evolution and syndrome of heart failure where it is mostly non- ischemic in origin yet there are few studies on the association of the individual blood parameters and heart failure. Objective: The study assessed the individual blood pressure parameters as prognosticators of congestive heart failure (CHF) in hypertensive patients. Method: A retrospective study was carried out at Kiambu County Hospital, on 205 heart failure patients who met the Framingham Criteria. The parameters observed included the time of onset of CHF, systolic/ diastolic blood pressure, pulse pressure and their duration to the development of CHF. Multivariable cox proportional hazard regression models were used to determine the effects of individual blood pressure parameters relative to the onset of CHF. Results: Overall, 205 patients were eligible for the study. Median time to CHF was estimated to be 4 years (range: 1-18), median age of CHF development was 65.7 years with a 68.8% female preponderance. Pulse pressure of 55- 60 mm Hg (AHR: 2.21; 95%CI: 1.16-4.21), hypertension duration of 5-10 years (AHR: 0.14; 95%CI: 0.088-0.223) and over 10 years (AHR: 0.023; 95%CI: 0.010-0.050) were significantly associated with the development of CHF. Conclusion: Pulse pressure is a better prognosticator of CHF in hypertensive patients with a hazard ratio of 2.2 times more likely in patients with a pulse pressure of 55- 60 mmHg than those below 55mm Hg.
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Mac’oduol et al. (2020) conducted a cross-sectional in Congestive heart failure in hypertensive patients (n=205). Pulse pressure of 55-60 mm Hg vs. Pulse pressure < 55 mm Hg was evaluated on Development of congestive heart failure (AHR 2.21, 95% CI 1.16-4.21, p=0.016). In hypertensive patients, a pulse pressure of 55-60 mm Hg was associated with a 2.21-fold increased hazard of developing congestive heart failure compared to a pulse pressure below 55 mm Hg.
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