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Title: Prognostic Significance of Low Systolic Blood Pressure at Discharge in Patients with Heart Failure and Preserved Ejection Fraction.
Author: Li S, Li X.
Journal: High Blood Press Cardiovasc Prev; 2017 Dec; 24(4):405-412. PubMed ID: 28725953.
Abstract:
INTRODUCTION: Systolic blood pressure (SBP) is emerging as a predictor of outcome in chronic heart failure and low SBP has been shown to be related to higher mortality. AIM: To investigate the relationship between low SBP and long-term outcome in patients with heart failure with preserved ejection fraction (HFpEF). METHODS: We use prospectively collected data and recruited 297 patients with chronic HFpEF to investigate the relationship between low SBP at discharge and long-term outcome. SBP was recorded at discharge and analysed in a Cox regression model. The endpoint of interest was death from any cause. RESULTS: In follow-up period, the mortality rates were 61.4% for SBP <100 mmHg, and the survival rates decreased in SBP <100 mmHg as compared with the other SBP strata by using Kaplan-Meier analysis (χ ² = 22.95, log rank P < 0.001). Compared to SBP 140-159 mmHg (reference category), the unadjusted hazard ratios for mortality were 3.29 (95% CI 1.45-7.47, P = 0.004) for SBP <100 mmHg. On multivariate analysis, adjustment for all variables, there still was an inverse relation between SBP and all cause mortality with a threshold at 100 mmHg (P = 0.002) and the adjusted hazard ratios were 3.16 (95% CI 1.15-8.68, P = 0.026) for SBP <100 mmHg. CONCLUSIONS: SBP at discharge is an independent predictor of long-term outcome and affects all-cause mortality, and SBP <100 mmHg at discharge is associated with excess long-term mortality in HFpEF.

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