Prognostic value of ambulatory blood pressure values in elderly patients with heart failure. Results of the DICUMAP study

Camafort, Miguel; Jhund, Pardeep S.; Formiga, Francesç; Castro‐Salomó, Antoni; Arévalo‐Lorido, J.C.; Sobrino-Martínez, Javier; Manzano, Luís; Díez-Manglano, Jesús; Aramburu, Óscar; Babkowski, Miguel Camafort; Lorido, J.C. Arévalo; Martínez, J. Sobrino; Espinosa, Luís; Jiménez, José Luis; Cerezo, Jorge Gómez; Francisco, Jorge; Díez-Manglano, Jesús; Bodas, Óscar Aramburu; Amorós, Jordi Grau; Pérez-Barquero, Manuel Montero; Cortada, Gerard Torres; Vila, J.; Aguilar, José Manuel Varela; Cuevas, Gonzalo; Ordóñez, Fernando Salgado; Bailón, Manuel Méndez; Pizà, Núria Ribas

doi:10.1016/j.rceng.2020.11.010

Cited by 3 publications

(4 citation statements)

References 40 publications

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“…And found that those with riser BP pattern subgroup had a significantly higher incidence of the composite outcome than the other subgroups of HFpEF patients [45]. Our group has shown, that in older patients with chronic HF (76.3% with HFpEF), a nondipper or riser BP pattern measured by ABPM was associated with a higher risk of hospitalization and death due to HF [46].…”

Section: Heart Failurementioning

confidence: 49%

Role of ambulatory blood pressure monitoring in elderly hypertensive patients

2022

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Background Arterial hypertension is facing some changes in the last years. Its prevalence is increasing in elderly subjects. This growing prevalence is due to longer survival of the population worldwide, among other factors. On the other hand, recent guidelines have insisted in the relevance of out of office blood pressure measurements, to improve diagnostic and management of hypertension. Therefore, elderly subjects with hypertension could benefit from out of office blood pressure measurements, like ambulatory blood pressure measurements; nevertheless, there are very few or no specific recommendations regarding this. Aim In this review, we will gather the most important information about this subject. Results As hypertension in the elderly has some specific characteristics related to aging of the cardiovascular system, the most important aspect could be that these characteristics make ambulatory blood pressure measurement suitable for its use in elderly. Among those a higher prevalence of white coat hypertension, white coat phenomenon, and a higher nocturnal blood pressure and higher prevalence of nondipper and riser pattern, represent aspects that should be considered for better diagnostic and an improved management. Conclusion As the prevalence of hypertension will grow in the next years, more studies specifically directed to this subject are needed.

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Section: Heart Failurementioning

confidence: 49%

Role of ambulatory blood pressure monitoring in elderly hypertensive patients

2022

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“…Hypertension is known to be the main etiology of HF and lowering BP with antihypertensive drugs has reduced the risk for HF development. 23) However, several studies of patients with HF found that lower BP was related to worse prognoses, 24 25) and there is no consensus regarding the optimal target of BP in especially HFrEF. A study from the Korean HF registry showed a reverse J-curve relationship between the on-treatment systolic OBP and clinical events.…”

Section: Discussionmentioning

confidence: 99%

The Association Between On-treatment Ambulatory Central Blood Pressure and Left Ventricular Reverse Remodeling in Heart Failure With Reduced Ejection Fraction

Park

et al. 2023

Int J Heart Fail

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Background and Objectives Compared to office blood pressure (OBP), central blood pressure (CBP) and ambulatory blood pressure (BP) are known to be better markers for predicting cardiovascular events. We evaluated the association between left ventricular reverse remodeling (LVRR) and ambulatory CBP in heart failure with reduced ejection fraction (HFrEF). Methods This study retrospectively analyzed 93 patients who performed ambulatory CBP and brachial BP (BBP) monitoring from 2018 to 2020 within 1 year after diagnosis of HFrEF at a single tertiary center. We analyzed the association between on-treatment ambulatory BPs and LVRR on follow-up echocardiography. Results The mean age of participants was 59 years; 65.6% were men; mean LVEF was 29%. Ambulatory BP and follow-up echocardiography were done at 143 days (interquartile range [IQR], 64–267) and 454 days (IQR, 281–600) after diagnosis of HF, respectively. Baseline OBP was not different between 2 groups, but ambulatory systolic CBP was significantly higher in the LVRR group than the non-LVRR group (p=0.005). Systolic OBP (odds ratio [OR], 1.029; confidence interval [CI], 1.004–1.055; p=0.026), 24-hour ambulatory systolic CBP (OR, 1.048; CI, 1.015–1.082; p=0.004), and 24-hour ambulatory systolic BBP (OR, 1.049; CI,1.017–1.082; p=0.003) were associated with LVRR. Compared to ambulatory systolic CBP of 110–119 mmHg, 90–99 mmHg showed lower OR for LVRR. Conclusions Low on-treatment ambulatory systolic CBP was closely related to a lower likelihood of LVRR in HFrEF than the normal range. Ambulatory CBP measured during treatment of patients with HFrEF appears to be useful in predicting outcomes.

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“…Em nosso estudo, o grupo não-dipper apresentou taxas significativamente maiores de internação hospitalar, uso de diuréticos, IVAE, E/Em e E/VP, de acordo com a literatura. 20 A avaliação prognóstica de pacientes com insuficiência cardíaca grave é importante por causa disso alta morbimortalidade do grupo. Portanto, muitos métodos, como ecocardiografia, ressonância magnética cardíaca, MAPA de 24 horas, técnicas nucleares, cateterismo cardíaco, cintilografia de perfusão miocárdica e parâmetros laboratoriais, têm sido sugeridos para prever o prognóstico.…”

Section: Discussionunclassified

“…In our study, the non-dipper group exhibited significantly higher hospital admission rates, diuretic usage, LAVI, E/Em, and E/VP, consistent with the literature. 20 The prognostic evaluation of patients with severe heart failure is important because of this group’s high morbidity and mortality rate. Therefore, many methods, such as echocardiography, cardiac magnetic resonance imaging, 24-h ABPM, nuclear techniques, cardiac catheterization, myocardial perfusion scintigraphy, and laboratory parameters, have been suggested to predict prognosis.…”

Section: Discussionmentioning

confidence: 99%

A Relação entre o Estado Dipping Noturno, Aumento da Pressão Arterial Matinal e Internações Hospitalares em Pacientes com a Insuficiência Cardíaca Sistólica

Taş,

Edem

2023

Arquivos Brasileiros De Cardiologia

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Resumo Fundamento A hipertensão é um fator de risco conhecido para o desenvolvimento de insuficiência cardíaca. No entanto, há dados limitados para investigar a associação entre pico de pressão arterial matinal (PPAM), estado dipper, parâmetros ecocardiográficos e internações hospitalares em pacientes com insuficiência cardíaca sistólica. Objetivos Avaliar a relação entre aumento matinal da pressão arterial, padrão de pressão arterial não-dipper, parâmetros ecocardiográficos e internações hospitalares em pacientes com insuficiência cardíaca sistólica. Métodos Analisamos retrospectivamente os dados de 206 pacientes consecutivos com hipertensão e fração de ejeção do ventrículo esquerdo abaixo de 40%. Dividimos os pacientes em dois grupos de acordo com os resultados da monitoramento ambulatorial da pressão arterial (MAPA) de 24 horas: dippers (n=110) e não-dippers (n=96). O aumento matinal da pressão arterial foi calculado. Achados ecocardiográficos e internações hospitalares durante o acompanhamento foram anotados. A significância estatística foi definida como p < 0,05. Resultados O grupo de estudo foi composto por 206 pacientes com predominância do sexo masculino e idade média de 63,5 ± 16,1 anos. O grupo não-dipper teve significativamente mais internações hospitalares em comparação com os dippers. Houve correlação positiva entre PPAM e índice de volume do átrio esquerdo (r=0,331, p=0,001), relação entre velocidade de influxo mitral precoce e velocidade de propagação do fluxo (r= 0,326, p=0,001) e relação entre influxo mitral precoce velocidade e velocidade diastólica inicial do anel mitral (E/Em) (r= 0,314, p=0,001). Verificou-se que a PA não-dipper, PPAM e o padrão E/Em estão independentemente associados ao aumento das admissões hospitalares. Conclusão O PPAM está associado à disfunção diastólica e pode ser um preditor sensível de internação hospitalar em pacientes com insuficiência cardíaca sistólica.

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Prognostic value of ambulatory blood pressure values in elderly patients with heart failure. Results of the DICUMAP study

Cited by 3 publications

References 40 publications

Role of ambulatory blood pressure monitoring in elderly hypertensive patients

Role of ambulatory blood pressure monitoring in elderly hypertensive patients

The Association Between On-treatment Ambulatory Central Blood Pressure and Left Ventricular Reverse Remodeling in Heart Failure With Reduced Ejection Fraction

A Relação entre o Estado Dipping Noturno, Aumento da Pressão Arterial Matinal e Internações Hospitalares em Pacientes com a Insuficiência Cardíaca Sistólica

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