Effect of different blood pressure levels on short-term outcomes in hospitalized heart failure patients

Xiaojing Niu; Zimo Li; Yuan Kang; Mingxue Li; Rongrong Zhong; Jianli Tian

doi:10.1016/j.ijcrp.2023.200169

Effect of different blood pressure levels on short-term outcomes in hospitalized heart failure patients

Int J Cardiol Cardiovasc Risk Prev. 2023 Jan 13:16:200169. doi: 10.1016/j.ijcrp.2023.200169. eCollection 2023 Mar.

Authors

Xiaojing Niu¹, Zimo Li², Yuan Kang¹, Mingxue Li¹, Rongrong Zhong¹, Jianli Tian¹

Affiliations

¹ Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China.
² IFLYTEK Co.Ltd, Hefei 230088, China.

Abstract

Background: To investigate the influence of blood pressure (BP) level on short-term prognosis of heart failure (HF), the effect of the BP level on clinical end point events 3 months after discharge was observed.

Methods: A retrospective cohort study was performed on 1492 hospitalized HF patients. All patients were divided according to systolic blood pressure (SBP) per 20 mmHg and diastolic blood pressure (DBP) per 10 mmHg. Logistic regression analysis was used to analyze the relationship between BP level and heart failure rehospitalization, cardiac death, all-cause death and a composite end point of heart failure rehospitalization/all-cause death at 3 month follow-up after discharge.

Results: After multivariable adjustment, the relationship between SBP and DBP levels and outcomes followed an inverted J curve relationship. Compared with the reference group (110 < SBP≤130 mmHg), the risk of all end point events significantly increased in the SBP≤90 mmHg group included heart failure rehospitalization (OR 8.16, 95%CI 2.88-23.11, P < 0.001), cardiac death (OR 5.43, 95%CI 1.97-14.96, P = 0.001), all-cause death (OR 4.85, 95%CI 1.76-13.36, P = 0.002), and composite end point (OR 2.76, 95%CI 1.03-7.41, P = 0.044). SBP>150 mmHg significantly increased the risk of heart failure rehospitalization (OR 2.67, 95%CI 1.15-6.18, P = 0.022). Compared with.the reference group (65 < DBP≤75 mmHg), cardiac death (OR 2.64, 95%CI 1.15-6.05, P = 0.022) and all-cause death (OR 2.67, 95%CI 1.20-5.93, P = 0.016) was significantly increased in DBP≤55 mmHg group. There was no significant difference among subgroups according to left ventricular ejection fraction (P > 0.05).

Conclusions: There is a significant difference in the short-term prognosis 3 months after discharge in HF patients with different BP levels at discharge. There was an inverted J curve relationship between BP levels and prognosis.

Keywords: Blood pressure; Heart failure; J-curve; Prognosis.