Clin Hypertens.  2016 ;22(1):16. 10.1186/s40885-016-0051-z.

Prognostic value of systolic short-term blood pressure variability in systolic heart failure

Affiliations
  • 1Department of Cardiology, University Hospital of Rangueil, 1, Avenue Professeur Jean Poulhès, 31095 Toulouse, France.
  • 2Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.
  • 3Rangueil Medical School, Toulouse, France.
  • 4Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France.
  • 5Purpan Medical School, Toulouse, France.
  • 6Department of Pharmacology, Purpan Medical School, Toulouse, France.

Abstract

BACKGROUND
Traditional cardiovascular risk factors in the general population are usually correlated to a better prognosis in patients with chronic heart failure (HF). Most of the studies show that blood pressure variability (BPV) has noxious effect on general population but data are missing for patients with systolic HF. The aim of this study was to assess the prognostic impact of short-term blood pressure variability (BPV) in systolic HF.
METHODS AND RESULTS
We retrospectively studied 288 patients (60"‰±"‰12 years-old; 79 % male) referred to our tertiary center of HF for the management of their systolic HF (left ventricular ejection fraction was 28"‰±"‰9 %). All patients underwent ambulatory blood pressure monitoring (systolic BP: 110"‰±"‰15; diastolic BP: 68"‰±"‰10 and pulse pressure: 42"‰±"‰11 mmHg) and the prognostic impact of BPV was collected with a mean follow-up of 4.4"‰±"‰3.1 years. Twenty-five (9 %) patients were missing for follow-up. Among the others patients, 70 (27 %) cardiovascular events (cardiac deaths: 24 %; heart transplantation: 2 %) were recorded. By multivariate analysis BPV daytime (OR"‰="‰0.963, p"‰="‰0.033) and severe NYHA class (OR"‰="‰5.2, p"‰<"‰0.0001) were found as independent predictors of cardiac event. Patients with a systolic daytime BPV under a cut-off value of 19 mmHg had the poorest prognosis with an OR for cumulative events of 1.65 (IC95 % 1.1-2.7; p"‰<"‰0.04).
CONCLUSION
BPV is simple tool and a predictor of cardiac events in patients with systolic HF.

Keyword

Keywords; Heart failure; Blood pressure variability; Prognosis

MeSH Terms

Blood Pressure Monitoring, Ambulatory
Blood Pressure*
Follow-Up Studies
Heart Failure
Heart Failure, Systolic*
Heart Transplantation
Humans
Multivariate Analysis
Prognosis
Retrospective Studies
Risk Factors
Stroke Volume
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