Abstract
Background: Hypertension is the most important modifiable risk factor for worsening heart failure (HF) because hypertension increases cardiac work, which results in worsening left ventricular hypertrophy and development of coronary artery disease. We will determine risk fctors of BP control in different types of heart failure according to JNC 8 guideline. Method: Based on ACC/AHA guidelines, heart failure is classified as a reduced ejection fraction(HFrEF, EF <40), preserved ejection fraction (HFpEF, EF>50) and heart failure with an improved ejection fraction(HFpEF(i),EF≥40). 732 patients enrolled in our heart failure program were analyzed retrospectively. And 672 patients who had been followed from Jan 1 st ,2013 to June 30st 2015 were included. Multiple logistic regression analysis was performed to determine the relationship between hypertension and heart failure after adjusting for potential confounders. Results: Patients with three types of heart failure had different BP control rate. It was 67.5% (308/456) ,76.5%(104/136), 77.5%(62/80) in HFrEF, HFrEF, and HFpEF(i) based on JNC 8 guideline, respectively. Mean systolic BP was 127.1±17 mmHg in HFrEF, 129.0±21 mmHg in HFpEF and 124.4±18 mmHg in HFpEF(i). Obesity [Odds ratio (OR): 0.12,95% Confidence Interval(CI): 0.048-0.284] , ACE inhibitor or ARB [OR: 2.66, CI: 1.50-3.42] and lasix [OR: 1.90,CI: 1.07-3.40] and aspirin [OR 0.53, CI: 0.37-0.96] were noted to be related to controlled BP in HFrEF. Aspirin [OR 0.17, CI: 0.05-0.60] was significantly associated with controlled BP in HFpEF. And beta-blocker [OR: 0.07, CI: 0.01-0.62] and anti-lipid medication [OR: 4.76, CI: 1.73-5.89] were associated with BP control in HFpEF(i). Conclusion: In each type of heart failure, there was difference of risk factors related to BP control. Different medications were associated with control of BP in different types of heart failure. Patients may need to modify risk factors including types of medication to control BP according to types of heart failure. It might be leading to better heart failure management.
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