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Updated: Oct 17, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Association of Early Blood Pressure Decrease and Renal Function With Prognosis in Acute Heart Failure.

Yuya Matsue1, Iziah E Sama2, Douwe Postmus2

  • 1Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

JACC. Heart Failure
|October 10, 2021
PubMed
Summary
This summary is machine-generated.

A significant drop in systolic blood pressure (SBP) in acute heart failure patients increases risks for worsening renal function and death. However, worsening renal function does not influence the prognostic impact of SBP drop.

Keywords:
acute heart failureblood pressurerenal dysfunction

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Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Research

Background:

  • Acute heart failure (AHF) management involves monitoring blood pressure.
  • Early systolic blood pressure (SBP) drop is a potential indicator of adverse outcomes.
  • The interplay between SBP drop, worsening renal function (WRF), and prognosis in AHF requires further investigation.

Purpose of the Study:

  • To examine the association between early SBP drop and WRF in AHF patients.
  • To assess the impact of SBP drop on clinical outcomes, including cardiovascular death.
  • To investigate potential interactions between WRF and SBP drop on prognosis.

Main Methods:

  • A post hoc analysis of 6,544 patients from the RELAX-AHF-2 trial.
  • SBP drop was defined as the difference between baseline and the lowest SBP within 48 hours.
  • WRF was defined as an increase in serum creatinine ≥0.3 mg/dL by day 5.

Main Results:

  • A significant SBP drop was independently associated with increased risk of WRF (HR: 1.11), 5-day worsening heart failure (HR: 1.12), and 180-day cardiovascular death (HR: 1.09).
  • Adjustments were made for confounders, including baseline SBP.
  • No significant interaction was found between the prognostic value of SBP drop and the presence of WRF.

Conclusions:

  • In AHF patients, an early SBP drop is linked to higher rates of WRF, worsening heart failure, and 180-day cardiovascular mortality.
  • WRF did not modify the association between SBP drop and prognosis.
  • These findings highlight the importance of monitoring SBP trends in AHF.