The association between admission systolic blood pressure of heart failure patients with preserved systolic function and mortality outcomes

Abstract

IntroductionHeart failure is a major cause of death and disability and poses a significant public health concern. Approximately half of the patients admitted with heart failure, have preserved left ventricular ejection fraction. The association between systolic blood pressure (SBP) and long-term outcome in this group has not been well established. AimThe aim of our study is to evaluate the association between admission SBP and short term and long-term mortality outcomes in patients with heart failure and preserved systolic function. Methods1230 consecutive patients presenting with preserved left ventricular (LV) systolic function (defined as an LV ejection fraction ≥40%) were included in this survey. Patients were divided into quartiles according to admission SBP: low admission SBP (<127mmHg), intermediate admission SBP (128–145mmHg), high admission SBP (146–170mmHg) and very-high admission SBP (>170mmHg). Primary outcome included in hospital, one and four year mortality rates. ResultsElevated admission SBP was found to be associated with improved short and long-term mortality (HR=0.25 95% CI — 0.09–0.7, p=0.007 and HR=0.7 95% CI — 0.56–0.88, p=0.002 for the highest versus low SBP group, respectively). This finding was most notable in patients with acute heart failure and patients with ejection fraction≥50%. ConclusionElevated admission SBP is associated with a favorable short and long-term outcome in patients with heart failure and preserved systolic function. Key messageLow admission SBP is an independent predictor for short and long-term mortality in patients with HF and PSF.