In acute heart failure, lower systolic blood pressure was linearly associated with higher mortality in patients with LVEF ≤40% (HR 1.16 per 10 mmHg decrease; 95% CI 1.08-1.25; P<0.001).
Cohort (n=1,049)
Effect estimate: HR 1.16 (95% CI 1.08-1.25)
p-value: p=<0.001
AIMS: To evaluate the relationship between systolic blood pressure (SBP) and long-term mortality in patients with acute heart failure (AHF) stratified by ejection fraction (LVEF): reduced ( or =50%). METHODS AND RESULTS: We studied 1049 consecutive patients admitted with AHF. Systolic blood pressure was determined in the emergency department. Left-ventricular ejection fraction was categorized as or =50% (n = 587). Cox regression analysis was used for multivariable analysis. Mean age and SBP were 73 +/- 11 years and 150 +/- 36 mmHg, respectively. During a median follow-up of 18 months, 290 deaths (33.1%) were identified. Higher SBP was associated with lower mortality. In multivariable analysis, a differential effect of SBP across LVEF status was documented (P-value for interaction = 0.036). In linear models, SBP was shown to be inversely related with mortality in both groups (per 10 mmHg decrease): HR((LVEF > or = 50%)): 1.06, CI 95% = 1.01-1.11; P = 0.016, and HR((LVEF or =50%, SBP followed a J-shape curve. CONCLUSION: In patients with AHF, SBP showed a differential prognostic effect on mortality according to LVEF status; when LVEF was or =50% this relationship showed a J-shape pattern.
Núñez et al. (Fri,) conducted a cohort in acute heart failure (n=1,049). Systolic blood pressure was evaluated on long-term mortality (HR 1.16, 95% CI 1.08-1.25, p=<0.001). In acute heart failure, lower systolic blood pressure was linearly associated with higher mortality in patients with LVEF ≤40% (HR 1.16 per 10 mmHg decrease; 95% CI 1.08-1.25; P<0.001).