Readmission and mortality among heart failure patients with history of hypertension in a statewide database

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Hypertension is a major risk factor for heart failure (HF).
• Understanding temporal trends in HF readmission and mortality is crucial for improving patient outcomes.
• Previous studies have not fully elucidated long-term trends in this specific patient population.

Purpose of the Study:

• To examine temporal trends in readmission and mortality for heart failure patients with a history of hypertension.
• To identify predictors of heart failure readmission and cardiovascular mortality.
• To assess the impact of readmission on long-term mortality.

Main Methods:

• Retrospective cohort study using the Myocardial Infarction Data Acquisition System (MIDAS) database.
• Inclusion of 51,141 patients discharged with a first diagnosis of heart failure and a history of hypertension (2000-2014).
• Multivariable logistic regression used to analyze temporal trends in mortality, HF-specific readmissions, and all-cause readmissions up to 1 year post-discharge.

Main Results:

• All-cause readmission rates increased significantly during the study period (P < .001).
• Heart failure readmission rates and cardiovascular mortality remained relatively unchanged.
• Male gender, black race, comorbidities, and non-teaching hospital admission predicted higher readmission and mortality.
• Patients readmitted within one year had significantly higher 3-year all-cause mortality (P < .001).

Conclusions:

• While cardiovascular mortality in hypertensive heart failure patients remained stable, all-cause readmission rates increased.
• Readmission within one year is a significant predictor of increased long-term mortality.
• Targeted interventions for high-risk patient groups and improved post-discharge care are warranted to reduce readmissions and improve survival.