PP.36.06

Abstract

Objective: The diastolic heart failure reaches up to 40% of HF total cases and its prevalence increases with age. The aim of this study is to evaluate both the blood pressure variability and the physical efficiency variability in elderly people with diastolic heart failure. Design and method: 34 elderly subjects were included (15 males, 19 females, mean age 73 + 8) hospitalized with a diagnosis of heart failure. The design of the study included: 1)clinical measurement of blood pressure;2)NYHA class evaluation;3)electrocardiogram; 4)echocardiogram; 5)Short Physical Performance Battery (SPPB). Self-sufficient elderly subjects,with a reduced physical performance and with a SPPB score between 5 and 9 can be considered frail and at high risk of disability. Results: 69.3% subjects had hypertension. Prevalence of heart failure increased with age (77.3% > age 80). Mean blood pressure values were: SBP 149 + 13 mmHg and DBP 87 + 12 mmHg. 35.3% had controlled blood pressure. Among all cases 27 affected by diastolic heart failure had a 43.9% ejection fraction. During the hospitalization those in Class I NYHA had a higher percentage of worsening heart failure if affected by uncontrolled hypertension. Hypertensive patients in Class 2 or 3 NYHA had a similar recovery rate both wih controlled and uncontrolled hypertension. However hypertensive subjects showed a definite worsening in NYHA class due to heart failure (19%) versus controlled ones (4%). Through the same investigation we detected that a history of hypertension was an independent predictive factor of NYHA Class diastolic heart failure (p < 0.05).We also detected that the average number of hospitalization days was higher in elderly patients affected by heart failure in 2 or 3 NYHA Classes and uncontrolled hypertension (p < 0.05). At dismissal we even detected a minor physical efficiency value (mean score 6 in 87% patients) mostly in elderly subjects with heart failure in 2 or 3 NYHA Classes and uncontrolled hypertension. Conclusions: The prevalence of diastolic heart failure is relevant in hypertensive ageing people and it increases with age. The cases of this study showed a connection among diastolic heart failure, blood pressure and physical efficiency, that is predictive of frailty.