Abstract
Objective: Nocturnal hypertension is reported as a risk factor for cardiovascular disease. This study was to explore the potential association between nocturnal hypertension and heart failure (HF) rehospitalization in patients with HF and preserved ejection fraction(HFpEF). Design and method: Totally, 538 patients with HFpEF were consequently recruited in this study and followed up until they were readmitted for HF or the end of this study. Cox regression analysis was used to reveal the potential association between nighttime blood pressure (BP) levels, nocturnal hypertension and nocturnal BP patterns and HF rehospitalization. Kaplan-Meier curve was used to assess the cumulative events free rate between groups. Results: The mean age of the study population was 77.14±8.68 years, and 41.2% was men. After a median follow up duration of 10.93 (4.19, 21.13) months, 176 (32.7%) patients with HFpEF were readmitted for HF. Cox analyse had revealed that nighttime systolic blood pressure (BP) level (Hazards ratio(HR):1.018, 95% confidence interval(CI): 1.008-1.028, p = 0.001), nightime diastolic BP level (HR:1.024, 95%CI:1.007-1.042, p = 0.007), nocturnal hypertension (HR:1.688, 95%CI:1.229-2.317, p = 0.001) were associated with HF rehospitalizaiton. Kaplan-Meier analysis had demonstrated that patients with nocturnal hypertension had significantly lower events free rate (Log rank test, p<0.001). Furthermore, patients with a riser pattern had a higher risk of HF rehospitalization (HR:1.828, 95%CI:1.055-3.166, p = 0.031) and lower events free rate (Log rank test, p = 0.003) than those with a dipper pattern. Conclusions: Nighttime BP levels, nocturnal hypertension and a riser pattern are independently associated with HF rehospitalization in patients with HFpEF. Well controlled nighttime BP levels should be emphasized and considered in patients with HFpEF.
Published Version
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