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Low pulse pressure is independently related to elevated natriuretic peptides and increased mortality in advanced

Adriaan A Voors1, Colin J Petrie, Mark C Petrie

  • 1Department of Cardiology, Thoraxcenter, University Hospital Groningen, PO Box 30001, 9700 RB Groningen, The Netherlands. a.a.voors@thorax.azg.nl

European Heart Journal
|April 19, 2005
PubMed

Insights

In advanced heart failure, low pulse pressure (PP) independently predicts mortality. This finding was independent of mean arterial pressure and linked to higher natriuretic peptide levels.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Heart Failure Research

Background:

  • Increased pulse pressure (PP) predicts cardiovascular risk and mortality in mild chronic heart failure (CHF).
  • Decreased PP is linked to mortality in acute decompensated heart failure.
  • The prognostic value of PP in advanced CHF remains unknown.

Purpose of the Study:

  • To investigate the predictive value of pulse pressure (PP) for mortality in patients with advanced chronic heart failure (CHF).

Main Methods:

  • Cox proportional hazards regression analysis of 1901 patients with New York Heart Association Class III or IV CHF.
  • Analysis adjusted for mean arterial pressure (MAP) and other prognostic markers.
  • Measurement of natriuretic peptides (ANP, BNP) in a subgroup.

Main Results:

  • Lower PP independently predicted increased mortality in advanced CHF (HR 0.91 per 10 mmHg).
  • Below the median PP (45 mmHg), PP was a stronger mortality predictor than MAP.
  • Low PP correlated with increased atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) levels.

Conclusions:

  • Low pulse pressure (PP) is an independent predictor of mortality in advanced chronic heart failure (CHF).
  • Low PP is associated with elevated natriuretic peptide levels (ANP and BNP) in this patient group.
Abstract

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