PP.14.08] COULD HYPERTENSION IMPROVE PROGNOSIS IN HEART FAILURE?

Abstract

Objective: It has been suggested that higher blood pressure could be beneficial in HF patients. This might be related with a better functional cardiac reserve in case of high BP. Objective: to analyse the prevalence and prognostic value of hypertension in patients admitted to the hospital due to Acute HF (AHF). Design and method: The clinical records of patients, admitted in Internal Medicine due to AHF, during three years, were reviewed. The characteristics of patients-episodes were registered and key indicators of performance. Hypertension was diagnosed based on the personal history of hypertension. Logistic regression models were used to study clinical variables related with death or readmission. Results: The study sample included 188 episodes. One hundred and fifty-nine patients had only one episode during the period of study, whereas 10 had two hospitalizations and 3 three hospitalizations. Median age 80y, predominantly women (56.4%), with pEF (68.8%) and with multiple morbidities. As it was expected, CVRF were the main associated comorbidities followed by respiratory diseases, CKD and chronic anaemia. Hypertension was the most frequent CVRF, 142 (82.5%) followed by type 2 diabetes, 100 (58.1%) and dyslipidaemia, 84, (48.8%).The most prescribed antihypertensive drugs were diuretics (81.4%), followed by ARBs (41.3%), beta-blockers (35.5%) and CCB (34.9%). Thirty patients died during the hospitalization (15.9%). Deceased patients were significantly older than survivors (81.8y vs 78.1y, p-value = 0.043). In the logistic regression models, the main factors significantly associated with mortality during the hospitalization were to have had a previous episode of hospitalization during the past six months [OR 2.33 (1.04–5.19), p-value = 0.038), especially in the past three months [OR 3.02 (1.34–6.81), p-value = 0.007] and older age [OR 1.05 (1.00–1.11), p-value = 0.046). Hypertension appeared as a highly significance protective factor not only in the univariate but also in the multivariate models [OR 0.20 (0.07–0.53), p-value = 0.001] whereas there was not association for the case of rehospitalisation of mortality after one year. Conclusions: Previous diagnosis of hypertension or high blood pressure could be of protection against in-hospital mortality in HF patients but further studies in this setting are needed to better clarify this association.