Poor Outcomes in HFpEF With Low Systolic Blood Pressure

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A systolic blood pressure <120 mm Hg in patients with HFpEF may increase mortality risk.
A systolic blood pressure <120 mm Hg in patients with HFpEF may increase mortality risk.

HealthDay News — For hospitalized patients with heart failure with preserved ejection fraction (HFpEF), poor outcomes are seen in association with a systolic blood pressure (SBP) level <120 mm Hg, according to a study published in JAMA Cardiology.

Apostolos Tsimploulis, MD, from the Veterans Affairs Medical Center in Washington, DC, and colleagues conducted a propensity score-matched observational study of the Medicare-linked Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) registry involving 901 patients with SBP discharge levels <120 mm Hg and 901 patients with SBP discharge levels of ≥120 mm Hg.

The researchers found that 30-day mortality occurred in 10% and 5% of matched patients with discharge SPB <120 mm Hg or ≥120 mm Hg, respectively (hazard ratio [HR], 2.07). 

SBP levels <120 mm Hg correlated with elevated mortality risks at 1 year (39% vs 31%; HR, 1.36) and during a median follow-up of 2.1 years (HR, 1.17). SBP levels <120 mm Hg also correlated with elevated heart failure readmission risk at 30 days (HR, 1.47) but not at 1 or 6 years. For the combined end point of heart failure readmission or all-cause mortality associated with SBP levels <120 mm Hg, the HRs were 1.71, 1.21, and 1.12, respectively, at 30 days, 1 year, and overall.

"Among hospitalized patients with HFpEF, an SBP level <120 mm Hg is significantly associated with poor outcomes," the authors wrote. "Future studies need to prospectively evaluate optimal SBP treatment goals in patients with HFpEF."

Disclosures: Two authors disclosed financial ties to the pharmaceutical industry; OPTIMIZE-HF was sponsored by GlaxoSmithKline.

Reference

Tsimploulis A, Lam PH, Arundel C, et al. Systolic blood pressure and outcomes in patients with heart failure with preserved ejection fraction [published online February 14, 2018]. JAMA Cardiol. doi: 10.1001/jamacardio.2017.5365

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