Ji Hyun Lee1, Jun-Won Lee1, Young-Jin Youn1, Min Soo Ahn1, Sung Gyun Ahn1, Jang Young Kim1, Seung-Hwan Lee1, Junghan Yoon1, Jaewon Oh2, Seok-Min Kang2, Eun-Seok Jeon3, Dong-Ju Choi4, Kyu-Hyung Ryu5, Byung-Su Yoo6. 1. Division of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea. 2. Division of Cardiology, Yonsei University Severance Hospital, Seoul, Republic of Korea. 3. Division of Cardiology, Sungkyunkwan University Samsung Medical Center, Seoul, Republic of Korea. 4. Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 5. Division of Cardiology, Hallym University Medical Center, Hwaseong, Republic of Korea. 6. Division of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea. Electronic address: yubs@yonsei.ac.kr.
Abstract
BACKGROUND: Higher systolic blood pressure (SBP) has been reported to be associated with a better prognosis in heart failure (HF) patients. This study aimed to investigate the prognostic impact of hypertension in patients hospitalized with systolic HF. METHODS: Pooled analysis of data from three Korean observational studies was performed. Patients ≥18 years hospitalized with systolic HF (ejection fraction ≤45%) (n=3538) were compared for the incidence of 1-year all-cause mortality according to the presence of preexisting hypertension and SBP quartiles on admission. RESULTS: Patients with hypertension (prevalence, 51.6%) presented more often with diabetes (43.9% vs. 23.0%, p<0.001) and chronic kidney disease (14.1% vs. 5.7%, p<0.001). During the 1-year follow-up, patients with hypertension showed similar cumulative incidences of all-cause mortality as those without hypertension (8.3% vs. 8.4%, p=0.900). Conversely, patients with higher SBP on admission had a lower incidence of all-cause death (quartile 4 vs. 1: 6.7% vs. 11.3%, p for trend=0.004). In the multivariate analysis, an increase in SBP of 10 mmHg was associated with an 8.5% risk reduction of all-cause death (hazard ratio: 0.915, 95% confidence interval: 0.853-0.981, p=0.013). CONCLUSIONS: Higher SBP on admission was independently associated with a lower risk of 1-year all-cause mortality in systolic HF.
BACKGROUND: Higher systolic blood pressure (SBP) has been reported to be associated with a better prognosis in heart failure (HF) patients. This study aimed to investigate the prognostic impact of hypertension in patients hospitalized with systolic HF. METHODS: Pooled analysis of data from three Korean observational studies was performed. Patients ≥18 years hospitalized with systolic HF (ejection fraction ≤45%) (n=3538) were compared for the incidence of 1-year all-cause mortality according to the presence of preexisting hypertension and SBP quartiles on admission. RESULTS:Patients with hypertension (prevalence, 51.6%) presented more often with diabetes (43.9% vs. 23.0%, p<0.001) and chronic kidney disease (14.1% vs. 5.7%, p<0.001). During the 1-year follow-up, patients with hypertension showed similar cumulative incidences of all-cause mortality as those without hypertension (8.3% vs. 8.4%, p=0.900). Conversely, patients with higher SBP on admission had a lower incidence of all-cause death (quartile 4 vs. 1: 6.7% vs. 11.3%, p for trend=0.004). In the multivariate analysis, an increase in SBP of 10 mmHg was associated with an 8.5% risk reduction of all-cause death (hazard ratio: 0.915, 95% confidence interval: 0.853-0.981, p=0.013). CONCLUSIONS: Higher SBP on admission was independently associated with a lower risk of 1-year all-cause mortality in systolic HF.