Impact of antecedent hypertension on outcomes in patients hospitalized with severe forms of acute heart failure

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Publikace nespadá pod Filozofickou fakultu, ale pod Lékařskou fakultu. Oficiální stránka publikace je na webu muni.cz.
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FELŠŐCI Marián PAŘENICA Jiří ŠPINAR Jindřich VÍTOVEC Jiří WIDIMSKÝ Petr LINHART Ales VACLAVIK Jan MÁLEK Filip BAMBUCH Miroslav MIKLÍK Roman ŠPINAROVÁ Lenka BĚLOHLÁVEK Jan ČIHALÍK Čestmír JARKOVSKÝ Jiří

Rok publikování 2012
Druh Článek v odborném periodiku
Časopis / Zdroj ACTA CARDIOLOGICA
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.2143/AC.67.5.2174125
Obor Onkologie a hematologie
Klíčová slova Hypertension; pulmonary oedema; cardiogenic shock; heart failure; survival
Přiložené soubory
Popis Objective Even though several studies described a positive influence of elevated initial blood pressure on the outcome in acute heart failure (AHF), data specifically addressed to a population with severe AHF associated with antecedent hypertension, regardless of admission blood pressure values, are missing. Methods and results From the 4153 consecutive patients enrolled in the Czech AHF registry we selected 1343 patients who suffered from pulmonary oedema or cardiogenic shock and compared them according to the presence of antecedent hypertension. Demographic, clinical, laboratory, treatment profiles and mortality rates were assessed and predictors of short- and long-term outcome were identified. Patients with antecedent hypertension (n = 1053, 78%) were older (P < 0.001), more often women (P. 0.001), having more co-morbidities and a worse laboratory profile. A trend for worse survival of hypertensive patients was observed when compared to a non-hypertensive cohort (1-, 2-, 3-year survival 70.0, 61.5, 55.5% vs. 72.6, 68.2, 64.0%, P = 0.062). Age and creatinine levels were independently associated with mortality during the whole follow-up period (P < 0.001). Low left ventricular ejection fraction, need of mechanical ventilation, inotropic and vasopressor support, were adversely related to in-hospital mortality (P < 0.001). On the other hand, presence of initial tachycardia improved short-term outcome (P = 0.007). Long-term survival was worsened by initial atrial fibrillation (P = 0.036) and anaemia (P < 0.001) while the presence of de-novo AHF improved it (P = 0.009). Conclusions Long-term antecedent hypertension is not significantly correlated with mortality after an episode of severe AHF, but probably still participates in vascular and end-organ damage. Survival of these patients is determined by other associated co-morbidities.
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