Prognostic impact of preexisting hypertension and high systolic blood pressure at admission in patients hospitalized for systolic heart failure

BackgroundHigher systolic blood pressure (SBP) has been reported to be associated with a better prognosis in heart failure (HF) patients. This study aimed to investigate the prognostic impact of hypertension in patients hospitalized with systolic HF.MethodsPooled analysis of data from three Korean observational studies was performed. Patients ≥18 years hospitalized with systolic HF (ejection fraction ≤45%) (n = 3538) were compared for the incidence of 1-year all-cause mortality according to the presence of preexisting hypertension and SBP quartiles on admission.ResultsPatients with hypertension (prevalence, 51.6%) presented more often with diabetes (43.9% vs. 23.0%, p < 0.001) and chronic kidney disease (14.1% vs. 5.7%, p < 0.001). During the 1-year follow-up, patients with hypertension showed similar cumulative incidences of all-cause mortality as those without hypertension (8.3% vs. 8.4%, p = 0.900). Conversely, patients with higher SBP on admission had a lower incidence of all-cause death (quartile 4 vs. 1: 6.7% vs. 11.3%, p for trend = 0.004). In the multivariate analysis, an increase in SBP of 10 mmHg was associated with an 8.5% risk reduction of all-cause death (hazard ratio: 0.915, 95% confidence interval: 0.853–0.981, p = 0.013).ConclusionsHigher SBP on admission was independently associated with a lower risk of 1-year all-cause mortality in systolic HF.