NYMC Faculty Publications

Systolic Blood Pressure and Outcomes in Older Patients with HFpEF and Hypertension

Author Type(s)

Faculty

DOI

10.1016/j.amjmed.2020.08.030

Journal Title

The American Journal of Medicine

First Page

252

Last Page

263

Document Type

Article

Publication Date

4-2021

Department

Medicine

Abstract

BACKGROUND: New hypertension and heart failure guidelines recommend that systolic blood pressure (SBP) in patients with heart failure with preserved ejection fraction (HFpEF) and hypertension be lowered toHg.

METHODS: Of the 6778 hospitalized patients with HFpEF and a history of hypertension in the Medicare-linked OPTIMIZE-HF registry, 3111 had a discharge SBPHg, we assembled a matched cohort of 1979 pairs with SBP≥130 mm Hg, balanced on 66 baseline characteristics (mean age, 79 years; 69% women; 12% African American). We then assembled a second matched cohort of 1326 pairs with SBP≥130 mm Hg. Hazard ratios (HRs) and 95% confidence intervals (CIs) for outcomes associated with SBP≥130 mm Hg as the reference.

RESULTS: HRs (95% CIs) for 30-day, 12-month, and 6-year all-cause mortality associated with SBP(0.91-1.59; P = 0.200), 1.11 (0.99-1.26; P = 0.080), and 1.05 (0.98-1.14; P = 0.186), respectively. Respective HRs (95% CIs) associated with SBP(1.21-2.34; P = 0.002), 1.28 (1.11-1.48; P = 0.001), and 1.11 (1.02-1.22; P = 0.022). There was no association with readmission.

CONCLUSIONS: Among older patients with HFpEF and hypertension, compared with SBP ≥130 mm Hg, the new target SBPpatients.

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