Elevated Systolic blood pressure improves outcomes in patients with Acute HF: Study

Elevated Systolic blood pressure (SBP) is associated with favorable short-term and long-term outcomes in patients with Acute HF, finds a new study. Systolic blood pressure (SBP) is an essential clinical characteristic in acute heart failure (AHF). SBP ranges from 100 mm Hg to more than 180 mm Hg in AHF patients. 

The findings of the study conducted by Johannes Grand and team were published in Journal of the American heart Association on 13th September, 2021.

This study looked at the relationship between SBP and short and long-term results in a large group of patients with AHF, as well as patients with decreased or maintained LVEF in patients hospitalized for AHF and randomly allocated to four big clinical trials.

This is a meta-analysis of four randomized controlled studies that compared serelaxin to placebo in patients hospitalized with AHF with SBPs ranging from 125 to 180 mm Hg. The outcomes were all cause mortality at 180 days and a composite end point of all cause death, worsening heart failure, or hospital readmission for heart failure within the first 14 days. The left ventricular ejection fraction (LVEF) was calculated as LVEF40% and LVEF40%. Multivariable Cox regression models were used to account for known confounders of AHF outcomes.

The findings revealed that a normal baseline SBP was substantially linked with a greater frequency of both 180day mortality and short-term outcome when compared to a moderately raised SBP. In patients with LVEF40 percent, baseline SBP was not related with death, while it was substantially associated with mortality in patients with LVEF40 percent. The findings suggest that, even in the absence of hypotension, low SBP is an independent risk factor for poor outcome when compared to moderately raised SBP.

In conclusion, higher SBP is linked with better short-term and long-term outcomes in individuals hospitalized for AHF without shock. This relationship was more evident in individuals with LVEF40 percent; however, there was no association between SBP and mortality in patients with LVEF40 percent.

Reference:

Grand, J., Miger, K., Sajadieh, A., Køber, L., Torp‐Pedersen, C., Ertl, G., López‐Sendón, J., Pietro Maggioni, A., Teerlink, J. R., Sato, N., Gimpelewicz, C., Metra, M., Holbro, T., & Nielsen, O. W. (2021). Systolic Blood Pressure and Outcome in Patients Admitted With Acute Heart Failure: An Analysis of Individual Patient Data From 4 Randomized Clinical Trials. Journal of the American Heart Association, 10(18). https://doi.org/10.1161/jaha.121.022288