Related Experiment Video
Updated: Jul 2, 2025
Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
Published on: October 1, 2019
Correlation between systolic blood pressure and mortality in heart failure patients with hypertension
Xueyan Lang1,2, Cheng Peng1,2, Yanxiu Zhang1,2
1The Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.
Insights
Systolic blood pressure below 130 mmHg is linked to higher mortality in heart failure with reduced ejection fraction (HFrEF) patients. This trend was also seen in heart failure with mid-range ejection fraction (HFmrEF), but not in HFpEF.
Area of Science:
- Cardiology
- Hypertension Research
- Heart Failure Studies
Background:
- Optimal systolic blood pressure (SBP) targets for hypertensive heart failure (HF) patients with varying ejection fractions (EF) are not well-established.
- Previous studies have not adequately explored the relationship between SBP and mortality across different HF phenotypes.
Purpose of the Study:
- To investigate the association between SBP levels and prognosis in hypertensive patients across all heart failure (HF) phenotypes.
- To determine if SBP <130 mmHg impacts mortality differently in heart failure with reduced ejection fraction (HFrEF), mid-range ejection fraction (HFmrEF), and preserved ejection fraction (HFpEF).
Main Methods:
- A retrospective cohort study analyzed 1279 hypertensive HF patients.
- Patients were categorized into SBP <130 mmHg (383 patients) and SBP ≥130 mmHg (896 patients) groups.
- The primary endpoint was all-cause mortality over a 1-year follow-up period.
Main Results:
- In patients with HFrEF, SBP <130 mmHg was significantly associated with increased all-cause mortality (HR 2.53) and cardiovascular death (HR 1.91).
- A trend towards increased mortality was observed in HFmrEF patients with SBP <130 mmHg, though not statistically significant.
- No increased mortality risk was observed in HFpEF patients with SBP <130 mmHg.
Conclusions:
- Lower systolic blood pressure (<130 mmHg) is linked to higher all-cause and cardiovascular mortality in hypertensive patients with HFrEF.
- The association between lower SBP and mortality risk shows a trend in HFmrEF patients but is not evident in HFpEF patients.
Background:
The correlation between systolic blood pressure (SBP) and mortality in hypertensive patients with different phenotypes of heart failure (HF) has not been adequately studied, and optimal blood pressure control targets remain controversial. To explore the link between SBP and prognosis in all or three ejection fraction (EF) phenotypes of HF patients with hypertension.
Methods:
We analyzed 1279 HF patients complicated by hypertension in a retrospective cohort. The SBP <130 mmHg group included 383 patients, and the SBP ≥130 mmHg group included 896 patients. The major end point was all-cause mortality.
Results:
Of the 1279 study patients, with a median age of 66.0 ± 12.0 years, 45.3% were female. The proportions of the three subtypes of heart failure complicated with hypertension (HFrEF, HEmrEF, and HFpEF) were 26.8%, 29.3%, and 43.9%, respectively. During the 1-year follow-up, 223 patients experienced all-cause death, and 133 experienced cardiovascular death. Restricted cubic splines showed that the risk of all-cause and cardiovascular death increased gradually as the SBP level decreased in patients with HFrEF and HFmrEF. Furthermore, the multivariate Cox proportional hazards model revealed that SBP <130 mmHg was also associated with an increased risk of all-cause death [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.23-5.20, P = 0.011] and cardiovascular death (HR 1.91, 95% CI 1.01-3.63, P = 0.047) in HFrEF patients. A trend toward increased risk was observed among HFmrEF patients, but it was not statistically significant. This trend was not observed in HFpEF patients.
Conclusion:
In HFrEF patients, SBP <130 mmHg was associated with an increased risk of all-cause and cardiovascular mortality. A trend toward increased risk was observed among HFmrEF patients, but not among HFpEF patients.
More Related Videos
Related Concept Videos
01:17Measurement of Blood Pressure
01:17Pathophysiology of Heart Failure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:24Blood Pressure
01:18Disorders of the Autonomic Nervous System
Raynaud's disease, also known as Raynaud's...
01:25Errors occurring during blood pressure monitoring
Several factors...