Early Drop in Systolic BP Associated With All-Cause Mortality in Acute HF

Early drop in systolic blood pressure (BP) during the first 48 hours of hospitalization is associated with all-cause mortality in patients with acute heart failure (HF), according to study results presented at the American Heart Association (AHA) Scientific Sessions 2021, held from November 13 to 15, 2021.

For the current study, researchers conducted a subanalysis of the Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure (REALITY-AHF) study, which registered patients with acute HF, who had been admitted through the emergency department (ED). A peak drop in systolic BP was determined by taking the difference between the baseline systolic BP values and the lowest values during the first 48 hours of hospitalization. Systolic BP was measured at the time of admission, then at 90 minutes, 6 hours, 24 hours, and 48 hours of ED admission. The registered patients were also divided into 3 groups according to the value of peak systolic BP drop.

The study data indicated that a greater peak systolic BP drop was associated with higher baseline systolic BP and vasodilator use after admission. According to Cox proportional hazard analysis, greater peak systolic BP drop (per 10 mm Hg decrease) was independently associated with 180-day (hazard ratio [HR], 1.12; 95% CI, 1.01-1.23; P =.027) and 1-year (HR, 1.12; 95% CI, 1.03-1.21; P =.006) mortality, even after adjusting for confounding factors like baseline systolic BP.

“Early drop in [systolic] BP during first 48 hours of hospitalization was associated with all-cause mortality in patients with acute heart failure,” the study authors concluded.

Reference

Dotare T, Maeda D, Sunayama T, et al. Prognostic implication of early drop in systolic blood pressure during the first 48 hours in patients with acute heart failure from REALITY-AHF Registry. Presented at: AHA Scientific Sessions 2021; November 13-15, 2021. Poster P11613.