Abstract
Objectives: Blood pressure (BP) is a prognostic marker of heart failure with reduced ejection fraction (HFrEF). We find hypertensive crisis not uncommon in patients who complain of dyspnea. We aimed to determine the correlation between BP level and time to recovery in patients with HFrEF visiting the emergency department (ED). Methods: This observational study included patients aged /> 19 years who visited an ED between 2015 and 2018 for dyspnea. We analyzed the BP, clinical outcomes, and prognosis of 1136 patients with HFrEF, excluding patients with acute myocardial infarction or valvular heart disease, among 2690 patients. Patients were divided into four groups according to their initial BP level based on the ESC/ESH hypertension guideline. The hypertensive crisis was defined as systolic BP /> 180 mmHg and/or diastolic BP /> 110 mmHg, which was equivalent to grade 3 hypertension. Results: Among the 1136 patients, 638 (56.2%) were below high normal BP, 236 (20.8%) showed grade 1 hypertension, 169 (14.9%) showed grade 2 hypertension, and 93 (8.2%) showed grade 3 hypertension. The recovery rate of heart failure for 3 years by the group was 21.6%, 32.1%, 38.3%, and 62.7%. The time to recovery was 32.1, 28.3, 15.7, and 7.4 months for each group. Conclusions: The hypertensive crisis had a relatively good prognosis in patients with HFrEF when adequate BP control was achieved.
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