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• W4379791569 abstract "Objective: Blood pressure (BP) management is complex in patients with heart failure (HF), but is important with respect to HF progression and clinical prognosis. We evaluated the actual prescribing patterns of angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB) and beta-blockers (BB) in patients with HF at discharge and clinical prognosis according to initial BP level in patients with acute HF.Design and method: Study data were obtained from a multicenter cohort that included patients hospitalized for acute HF. Patients who had available data regarding initial BP and left ventricular ejection fraction were included in this analysis. The patients were classified into two groups: heart failure reduced ejection fraction (HFrEF) group versus. HF mildly reduced ejection fraction (HFmrEF) and HF preserved ejection fraction (HFpEF) group. Initial systolic blood pressure (SBP) was classified into <100, 100-119, 120-139, 140-159, and > = 160mmHg, and diastolic blood pressure (DBP) into <50, 50-69, 70-89, 90-109, > = 110mmHg. Results: Among 2,778 patients, HFrEF patients used ACEi, ARB, or BB at discharge even if their SBP was as low as less than 100mmHg, and there was no significant difference in frequency of medication use by BP level. However, HFmrEF and HFpEF patients showed a tendency to significantly decrease the frequency of medication use as BP decreased. In HFrEF, the lower the initial BP, the higher the incidence of all-cause death and composite clinical events including HF readmission or all-cause death (Table). However, in HFpEF and HFmrEF, there was no significant difference in clinical outcome according to BP. In addition, initial SBP (<120mmHg) was independently associated with 1.81-fold increased risk of long-term mortality [Odds ratio (OR) 1.81, 95% confidence interval (CI) 1.349-2.417, p < 0.001], and initial DBP (<80mmHg) was also 2.24-fold increased risk [OR 2.24, 95% CI 1.645-3.053, p < 0.001]. Conclusions: Poor clinical prognosis is expected if the initial BP low in patients with HFrEF, and low BP (<120/80mmHg) affects increased mortality independently of HF medication use. Clinicians should be aware of the effect of low BP in patients with acute HF and provide delicate BP control." @default.
• W4379791569 created "2023-06-09" @default.
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• W4379791569 date "2023-06-01" @default.
• W4379791569 modified "2023-09-23" @default.
• W4379791569 title "EFFECT OF LOW BLOOD PRESSURE ON ACUTE HEART FAILURE PROGNOSIS ACCORDING TO HEART FAILURE CLASSIFICATION" @default.
• W4379791569 doi "https://doi.org/10.1097/01.hjh.0000939636.95426.83" @default.
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