NYMC Faculty Publications
Systolic Blood Pressure and Outcomes in Older Patients with HFpEF and Hypertension
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.
Faselis, C., Lam, P. H., Zile, M. R., Bhyan, P., Tsimploulis, A., Arundel, C., Patel, S., Kokkinos, P., Deedwania, P., Bhatt, D. L., Zeng-Trietler, Q., Morgan, C. J., Aronow, W. S., Allman, R. M., Fonarow, G. C., & Ahmed, A. (2021). Systolic Blood Pressure and Outcomes in Older Patients with HFpEF and Hypertension. The American Journal of Medicine, 134 (4), 252-263. https://doi.org/10.1016/j.amjmed.2020.08.030