| Impact of baseline systolic blood pressure on long-term outcomes in patients with advanced chronic systolic heart failure (insights from the BEST trial). | |
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MedLine Citation:
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PMID: 20599007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-05 Completed Date: 2010-08-03 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 221-7 Citation Subset: AIM; IM |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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University of Alabama at Birmingham, AL, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Pressure* Female Heart Failure, Systolic / mortality* Humans Male Middle Aged Risk Assessment Risk Factors Severity of Illness Index Systole Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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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 |
| Comments/Corrections | |
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