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DBP & Adverse Outcomes in Patients with HFpEF

J Am Heart Assoc; ePub 2018 Feb 23; Sandesara, et al

In patients with heart failure with preserved ejection fraction (HFpEF) treated for hypertension, diastolic blood pressure (DBP) values ≥90 and <60 mm Hg are associated with a significant risk of adverse outcomes, a recent study found. The analysis included 1,703 (mean age 72±10 years, 78% white) patients with HFpEF enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial who were treated for hypertension. The risk of hospitalization for HF, death, and CV death associated with DBP was examined. Researchers found:

  • In patients with HFpEF, DBP values ≥90 and <60 mm Hg were associated with an increased risk of adverse events.
  • The risk of hospitalization for HF was greatest for patients with DBP values <60 mm Hg, whereas the risk for death and CV death demonstrated a U‐shaped association, with a greater risk observed with DBP values ≥90 and <60 mm Hg.

Citation:

Sandesara PB, O’Neal WT, Kelli HM, Topel M, Samman-Tahhan A, Sperling LS. Diastolic blood pressure and adverse outcomes in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) Trial. [Published online ahead of print February 23, 2018]. J Am Heart Assoc. doi:10.1161/JAHA.117.007475.

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