Prognostic value of ambulatory blood pressure values in elderly patients with heart failure. Results of the DICUMAP study
| Autor: | Javier Sobrino Martínez, Jesús Díez-Manglano, Jesús Díez Manglano, M. Montero Pérez-Barquero, Oscar Aramburu, Jorge Francisco, Manuel Montero Pérez-Barquero, Nuria Ribas Pizá, José Carlos Arévalo Lorido, Gerard Torres Cortada, Luis Manzano Espinosa, Fernando Salgado Ordóñez, Manuel Méndez Bailón, José Luis Arias Jiménez, Miguel Camafort, Óscar Aramburu Bodas, J. Vila, Francesc Formiga, A. Castro-Salomó, Javier Sobrino-Martinez, J.C. Arévalo-Lorido, Jorge Gómez Cerezo, Gonzalo Martínez de las Cuevas, José Manuel Varela Aguilar, Luis Manzano, Jordi Grau Amorós, Pardeep S. Jhund, Miguel Camafort Babkowski |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ambulatory blood pressure Diastole Blood Pressure Nyha class Ventricular Dysfunction Left 03 medical and health sciences 0302 clinical medicine Older patients Risk Factors Internal medicine Humans Medicine Prospective Studies 030212 general & internal medicine Aged Heart Failure Ejection fraction Proportional hazards model business.industry Hazard ratio Stroke Volume General Medicine Blood Pressure Monitoring Ambulatory Prognosis medicine.disease Heart failure Cardiology Female business |
| Zdroj: | Revista Clínica Española (English Edition). 221:433-440 |
| ISSN: | 2254-8874 |
| Popis: | Introduction Ambulatory blood pressure monitoring (ABPM) has demonstrated value in the prognostic assessment of hypertensive patients with heart failure (HF) with or without other cardiovascular diseases. The objective of this study was to evaluate whether ABPM can identify subjects with HF with a worse prognosis. Methods and results Prospective multicenter study that included clinically stable outpatients with HF. All patients underwent ABPM. A total of 154 patients from 17 centers were included. Their mean age was 76.8 years (± 8.3) and 55.2% were female. In total, 23.7% had HF with a reduced ejection fraction (HFrEF), 68.2% were in NYHA functional class II, and 19.5% were in NYHA functional class III. At one year of follow up, there were 13 (8.4%) deaths, of which 10 were attributed to HF. Twenty-nine patients required hospitalization, of which 19 were due to HF. The presence of a non-dipper BP pattern was associated with an increased risk for readmission or death at one year of follow-up (25% vs. 5%; p = .024). According to a Cox regression analysis, more advanced NYHA functional class (hazard ratio 3.51; 95% CI 1.70–7.26; p = .001; for NYHA class III vs. II) and a higher proportional nocturnal reduction in diastolic BP (hazard ratio 0.961; 95%CI 0.926−0.997; p = .032 per 1% diastolic BP reduction) were independently associated with death or readmission at one year. Conclusion In older patients with chronic HF, a non-dipper BP pattern measured by ABPM was associated with a higher risk of hospitalization and death due to HF. |
| Databáze: | OpenAIRE |
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