کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5927407 1167711 2011 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Association of systolic blood pressure with mortality in patients with heart failure with reduced ejection fraction: A complex relationship
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Association of systolic blood pressure with mortality in patients with heart failure with reduced ejection fraction: A complex relationship
چکیده انگلیسی

BackgroundIn ambulatory patients with heart failure with reduced ejection fraction (HFrEF), high systolic blood pressure (SBP) is associated with better outcomes. However, it is not known whether there is a ceiling beyond which high SBP has a detrimental effect. Thus, our aim was to assess the linearity of association between SBP and mortality.MethodsWe used the External Peer Review Program (EPRP) and Digitalis Investigation Group (DIG) trial databases of HFrEF patients. Linearity of association of SBP with mortality was assessed by plotting Martingale residuals against SBP. To assess the patterns of relationship of SBP with mortality, we used restricted cubic spline analysis with Cox proportional hazards model.ResultsIn patients with mild-to-moderate left ventricular systolic dysfunction (LVSD) (30% ≤ LVEF < 50%), SBP had a nonlinear association with mortality in both EPRP (n = 3,693) and DIG (n = 3,263) databases. In these patients, SBP had a significant U-shaped association with mortality in EPRP and a trend toward U-shaped relationship in DIG database. In patients with severe LVSD (LVEF <30%), SBP had a linear association with mortality in both EPRP (n = 2,906) and DIG (n = 3,537) databases, with lower SBP being associated with increased mortality.ConclusionsSystolic blood pressure has a complex nonlinear association with mortality in patients with heart failure. Whereas it has a U-shaped association in patients with mild-to-moderate LVSD, it has a linear association with mortality in patients with severe LVSD. Recognition of this pattern of association of blood pressure profile may help clinicians in providing better care for their patients and help improve existing prediction models.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: American Heart Journal - Volume 161, Issue 3, March 2011, Pages 567-573
نویسندگان
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