Document Detail


Change in blood pressure during hospitalisation for acute heart failure predicts mortality.
MedLine Citation:
PMID:  21080863     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: In patients with acute heart failure (HF) there is an inverse relation between blood pressure (BP) and mortality but the prognostic impact of the change in BP between admission and discharge is not known. The primary objective was to study the impact of the change in BP during a hospitalisation for acute HF on prognosis.
DESIGN: We studied 208 consecutive patients admitted with acute heart failure and discharged alive, age 77 ± 10 years, 49.5% women.
RESULTS: BP at admission was 145 ± 35/85 ± 9 mmHg compared to 132 ± 24/76 ± 13 mmHg at discharge. The average number of BP lowering medications at admission and discharge was 2.1 ± 1.2 and 2.8 ± 1.0 respectively. The average number of BP lowering medications with dose increased at discharge compared to admission was 0.3 ± 0.5. Univariate predictors of all-cause mortality at 12 and/or 40 months were admission SBP and DBP, discharge DBP, decrease in SBP and DBP during hospitalisation, age, eGFR, number of added BP-lowering medications during the hospitalisation and left ventricular ejection fraction (LVEF). Multivariate predictors at 12 and/or 40 month were admission DBP, decrease in DBP, age, eGFR, LVEF and number of new BP-lowering medications added during the hospitalisation.
CONCLUSIONS: A decrease in BP during hospitalisation for acute heart failure was a predictor of all cause mortality. A higher admission BP and the tolerability of added medications probably played a role, and our findings need confirmation in larger studies.
Authors:
Per Svensson; Helena Sundberg; Lars H Lund; Jan Östergren
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  44     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  325-30     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Karolinska University Hospital-Solna, Stockholm, Sweden. per.svensson@karolinska.se
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