Document Detail

Impact of baseline systolic blood pressure on long-term outcomes in patients with advanced chronic systolic heart failure (insights from the BEST trial).
MedLine Citation:
PMID:  20599007     Owner:  NLM     Status:  MEDLINE    
The impact of baseline systolic blood pressure (SBP) on outcomes in patients with advanced chronic systolic heart failure (HF) has not been studied using a propensity-matched design. Of the 2,706 participants in the Beta-Blocker Evaluation of Survival Trial (BEST) with chronic HF, New York Heart Association class III to IV symptoms and left ventricular ejection fraction < or =35%, 1,751 had SBP < or =120 mm Hg (median 108, range 70 to 120) and 955 had SBP >120 mm Hg (median 134, range 121 to 192). Propensity scores for SBP >120 mm Hg, calculated for each patient, were used to assemble a matched cohort of 545 pairs of patients with SBPs < or =120 and >120 mm Hg who were balanced in 65 baseline characteristics. Matched Cox regression models were used to estimate associations between SBP < or =120 mm Hg and outcomes over 4 years of follow-up. Matched participants had a mean age +/- SD of 62 +/- 12 years, 24% were women, and 24% were African-American. HF hospitalization occurred in 38% and 32% of patients with SBPs < or =120 and >120 mm Hg, respectively (hazard ratio 1.33 SBP < or =120 was compared to >120 mm Hg, 95% confidence interval 1.04 to 1.69, p = 0.023). All-cause mortality occurred in 28% and 30% of matched patients with SBPs < or =120 and >120 mm Hg, respectively (hazard ratio 1.13 SBP < or =120 compared to >120 mm Hg, 95% confidence interval 0.86 to 1.49, p = 0.369). In conclusion, in patients with advanced chronic systolic HF, baseline SBP < or =120 mm Hg is associated with increased risk of HF hospitalization, but had no association with all-cause mortality.
Ravi V Desai; Maciej Banach; Mustafa I Ahmed; Marjan Mujib; Inmaculada Aban; Thomas E Love; Michel White; Gregg Fonarow; Prakash Deedwania; Wilbert S Aronow; Ali Ahmed
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-08-03     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  221-7     Citation Subset:  AIM; IM    
Copyright Information:
Published by Elsevier Inc.
University of Alabama at Birmingham, AL, USA.
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MeSH Terms
Blood Pressure*
Heart Failure, Systolic / mortality*
Middle Aged
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Grant Support
R01 HL085561-04/HL/NHLBI NIH HHS; R01 HL097047-01/HL/NHLBI NIH HHS; R01-HL085561/HL/NHLBI NIH HHS; R01-HL097047/HL/NHLBI NIH HHS

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