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Poor Outcomes With Systolic BP Below 120 mm Hg in HFpEF

Increased risk of heart failure readmission at 30 days; of mortality, combined end point at 30 days, one year

WEDNESDAY, Feb. 14, 2018 (HealthDay News) — For hospitalized patients with heart failure with preserved ejection fraction (HFpEF), poor outcomes are seen in association with a systolic blood pressure (SBP) level below 120 mm Hg, according to a study published online Feb. 14 in JAMA Cardiology.

Apostolos Tsimploulis, M.D., from the Veterans Affairs Medical Center in Washington, D.C., and colleagues conducted a propensity score-matched observational study of the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry involving 901 patients with SBP discharge levels <120 mm Hg and 901 patients with SBP discharge levels of ≥120 mm Hg.

The researchers found that 30-day mortality occurred in 10 and 5 percent of matched patients with discharge SPB <120 mm Hg or ≥120 mm Hg, respectively (hazard ratio, 2.07). SBP levels <120 mm Hg correlated with elevated mortality risks at one year (39 versus 31 percent; hazard ratio, 1.36) and during a median follow-up of 2.1 years (hazard ratio, 1.17). SBP levels <120 mm Hg also correlated with elevated heart failure readmission risk at 30 days (hazard ratio, 1.47) but not at one or six years. For the combined end point of heart failure readmission or all-cause mortality associated with SBP levels <120 mm Hg, the hazard ratios were 1.71, 1.21, and 1.12, respectively, at 30 days, one year, and overall.

“Among hospitalized patients with HFpEF, an SBP level less than 120 mm Hg is significantly associated with poor outcomes,” the authors write. “Future studies need to prospectively evaluate optimal SBP treatment goals in patients with HFpEF.”

Two authors disclosed financial ties to the pharmaceutical industry; OPTIMIZE-HF was sponsored by GlaxoSmithKline.

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