Objective:Heart failure is a major public health problem and one of the leading causes of ospitalisation and death. Since HFPEF increases with age, it is an increasingly worrisome health problem in countries with higher life expectancies. Since the influence of BP is essential in HFPEF, and its control in the outpatient is not clear, we propose to evaluate this variable in a retrospective cohort.Design and method:Retrospective study of patients with HFPEF, older than 80 years, followed up in outpatient consultation after ospitalisation for HF, in a Teaching Hospital. Data were obtained from electronic medical records with prior authorization from the Ethics Committee.Results:106 patients were included. For analysis we use a cut-off point of SBP (measured in the office at the first visit) below 90 mmHg, between 90 and 139 mmHg and equal or above 140 mm Hg. For DBP we used a a cut-off point of DBP od 70 mmHg. As for the characteristics the only differences were that those with Low SBP had significantly lower LVEF as those with normal or high SBP (54% vs 59 p 0.035). As for DBP, those with low DBP had significantly lower Heart Rate than those with High DBP (72 bpm vs 79 bpm, p 0.039) There were no mortality differences between those with low SBP, normal SBP and high SBP, neither on those with low DBP or Normal High DBP. Kaplan Meier curve showed a non-significant trend to higher mortality on those with lower BPConclusions:In our study, we have not observed differences in mortality between those patients with BP with good control versus those with poor control.Although there may be a selection bias and this is a retrospective study, more studies are needed to assess the influence of BP controls on the evolution of HF in octogenarian patients
Objective:International guidelines recommend Ambulatory Blood Pressure Monitoring (ABPM) in the diagnosis and follow-up of hypertensive patients based on the superior reliability prognostic value compared to office BP. Our objective was to analyze the relationship between ABPM control and target organ damage (TOD) in the elderly population.Design and method:Observational, retrospective, longitudinal study of a cohort of treated hypertensive patients older than 75 years. A baseline ABPM was obtained in all patients and was repeated after 6 months follow-up. Clinical data on associated CVRF, TOD, cardiovascular events, and emergency room visits were collected at baseline and 6 months of follow-up.Results:A total of 39 consecutive patients were included, 38.5% women, mean age 80 years (75–89), 30% diabetic, 50% obese and 58% dyslipidemic. Previous stroke was observed in 5.6% patients and 9% had a previous acute myocardial infarction (AMI). The mean in-treatment office BP was 142 (± 22) / 71 (± 14) mm Hg and 30.8% were controlled (BP < 140/90 mmHg). The mean in-treatment 24-hour BP was 141 (± 15) / 70 (± 11) mm Hg. New CV events were observed in 19.7 during follow-up. When we compared the characteristics between the group with good ABPM (defined as mean 24 h BP < 130/80 mm Hg) and the group with poor control, only left ventricular mass index (LVMI) was significantly higher in the latter (170 g/m2 (poor control) vs. 128 g/m2 (good control); Anova p 0.044).Conclusions:In treated elderly hypertensive patients, poor BP control by 24h-ABPM is significantly correlated with a greater degree of LVH. Considering the retrospective design of this pilot study in a very limited number of patients, these findings need to be confirmed in larger studies.
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