Control of blood pressure in older patients with heart failure and the risk of mortality: a population-based prospective cohort study.
Age Ageing
; 50(4): 1173-1181, 2021 06 28.
Article
em En
| MEDLINE
| ID: mdl-33320927
ABSTRACT
BACKGROUND:
treatment goals for blood pressure (BP) lowering in older patients with heart failure (HF) are unclear.OBJECTIVE:
to assess whether BP control < 140/90 mmHg is associated with a decreased risk of mortality in older HF patients.DESIGN:
population-based prospective cohort study. SETTING/SUBJECTS:
participants of the Berlin Initiative Study, a prospective cohort of community-dwelling older adults launched in 2009. Clinical information was obtained in face-to-face interviews and linked to administrative healthcare data.METHODS:
Cox proportional hazards models estimated adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of cardiovascular death and all-cause mortality associated with normalised BP (systolic BP < 140 mmHg and diastolic BP < 90 mmHg) compared with non-normalised BP (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) in HF patients. The primary analysis considered only baseline BP ('time-fixed'); an additional analysis updated BP during follow-up ('time-dependent').RESULTS:
at baseline, 544 patients were diagnosed with HF and treated with antihypertensive drugs (mean age 82.8 years; 45.4% female). During a median follow-up of 7.5 years and compared with non-normalised BP, normalised BP was associated with similar risks of cardiovascular death (HR, 1.24; 95% CI, 0.84-1.85) and all-cause mortality (HR, 1.16; 95% CI, 0.89-1.51) in the time-fixed analysis but with increased risks of cardiovascular death (HR, 1.79; 95% CI, 1.23-2.61) and all-cause mortality (HR, 1.48; 95% CI, 1.15-1.90) in the time-dependent analysis.CONCLUSIONS:
BP control < 140/90 mmHg was not associated with a decreased risk of mortality in older HF patients. The increased risk in the time-dependent analysis requires further corroboration.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Insuficiência Cardíaca
/
Hipertensão
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Aged
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Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Age Ageing
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Canadá