Systolic blood pressure, a predictor of mortality and life expectancy following heart failure hospitalization, 2010-2023
Author Department
Hospital Medicine; Medicine
Document Type
Article, Peer-reviewed
Publication Date
10-2024
Abstract
Background: Optimal systolic blood pressure (SBP) targets for the treatment of hospitalized acute decompensated heart failure (ADHF) patients are not known.
Objectives: To investigate the association between SBP <130 mmHg at discharge or within 30 days and all-cause mortality or years of life lost (YLL) after ADHF hospitalization.
Methods: We analyzed medical records of 14,611 adults who survived ADHF hospitalization at 17 hospitals (2010-2022) with follow-up until May 2023. Sensitivity analysis included 10,515 patients with post-discharge SBP measured within 30 days.
Results: Mortality rates at 30 days, 180 days, 1 year, and 3 years were higher in patients with discharge SBP <130 mmHg (6.9 %, 21.1 %, 29.1 %, and 45.1 %) vs. SBP ≥130 mmHg (4.8 %, 16.0 %, 23.6 %, and 40.3 %). Hazard ratios (HR) for mortality were consistently higher in patients with discharge SBP <130 at 1.30 (95 % CI, 1.11-1.52), 1.45 (95 % CI, 1.33-1.58), 1.40 (95 % CI, 1.30-1.51), 1.31 (95 % CI, 1.23-1.38) at these intervals. The average YLL per deceased individual was 1-2 years greater in the discharge SBP <130 group (incidence rate ratios, 1.004 to 1.230). Restricted cubic spline analysis showed that HR for mortality shifted toward better outcomes at discharge SBP ≥130 Sensitivity analysis supported these findings.
Conclusion: In hospitalized ADHF patients, SBP <130 mmHg at discharge or within 30 days post-discharge was linked to higher mortality and YLL, while SBP ≥130 mmHg or improvement to ≥130 mmHg post-discharge led to better short and long-term outcomes. Further research is needed to understand the mechanisms and benefits of SBP optimization.
Keywords: And years of life lost; Heart failure; Mortality; Systolic blood pressure.
Recommended Citation
Yousufuddin M, Ma Z, Barkoudah E, Tahir MW, Issa M, Wang Z, Badr F, Gomaa IA, Aboelmaaty S, Al-Anii AA, Gerard SL, Abdalrhim AD, Bhagra S, Jahangir A, Qayyum R, Fonarow GC, Yamani MH. Systolic blood pressure, a predictor of mortality and life expectancy following heart failure hospitalization, 2010-2023. Eur J Intern Med. 2024 Oct 21:S0953-6205(24)00415-1. doi: 10.1016/j.ejim.2024.10.004. Epub ahead of print.
PMID
39438195