Nocturnal hypertension and riser pattern are associated with heart failure rehospitalization in patients with heart failure with preserved ejection fraction

作者全名："Huang, Gang; Liu, Xiao-Han; Zhang, Yue; Zhu, Yu-Xin; He, Yun; Wang, Tian-Bo; Zhang, Zhen; Xu, Jun-Bo"

作者地址："[Huang, Gang; He, Yun; Zhang, Zhen; Xu, Jun-Bo] Third Peoples Hosp Chengdu, Dept Cardiol, Chengdu, Sichuan, Peoples R China; [Huang, Gang; He, Yun; Wang, Tian-Bo; Zhang, Zhen; Xu, Jun-Bo] Cardiovasc Dis Res Inst Chengdu, Chengdu, Sichuan, Peoples R China; [Huang, Gang; Liu, Xiao-Han; Zhang, Yue; Zhu, Yu-Xin; He, Yun; Wang, Tian-Bo; Zhang, Zhen; Xu, Jun-Bo] Southwest Jiaotong Univ, Affiliated Hosp, Chengdu, Sichuan, Peoples R China; [Huang, Gang; He, Yun; Zhang, Zhen; Xu, Jun-Bo] Chongqing Med Univ, Affiliated Chengdu Clin 2, Chongqing, Sichuan, Peoples R China"

通信作者："Huang, G; Xu, JB (通讯作者)，Third Peoples Hosp Chengdu, Dept Cardiol, Chengdu, Sichuan, Peoples R China.; Huang, G; Xu, JB (通讯作者)，Cardiovasc Dis Res Inst Chengdu, Chengdu, Sichuan, Peoples R China.; Huang, G; Xu, JB (通讯作者)，Southwest Jiaotong Univ, Affiliated Hosp, Chengdu, Sichuan, Peoples R China.; Huang, G; Xu, JB (通讯作者)，Chongqing Med Univ, Affiliated Chengdu Clin 2, Chongqing, Sichuan, Peoples R China."

来源：JOURNAL OF GERIATRIC CARDIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001022226700004

JCR分区：Q3

影响因子：1.8

年份：2023

卷号：20

期号：6

开始页：448

结束页：458

文献类型：Article

关键词：　

摘要："BACKGROUND Nocturnal hypertension is reported as a risk factor for cardiovascular disease. This study aimed to explore the potential association between nocturnal hypertension and heart failure (HF) rehospitalization in patients with HF with preserved ejection fraction (HFpEF). METHODS A total of 538 patients with HFpEF from May 2018 to December 2021 were consequently recruited in this study and followed up until they were readmitted for HF or the end of this study. Cox regression analysis was used to reveal the potential association between nighttime blood pressure (BP) levels, nocturnal hypertension and nocturnal BP patterns and HF rehospitalization. Kaplan-Meier curve was used to assess the cumulative event-free survival rate between groups. RESULTS There were 537 patients with HFpEF were included in the final analysis. The mean age of the study population was 77.14 +/- 8.68 years, and 41.2% of patients were men. After a median follow-up duration of 10.93 (4.19-21.13) months, 176 patients (32.7%) with HFpEF were readmitted for HF. Cox regression analysis had revealed that nighttime systolic BP level [hazards ratio (HR) = 1.018, 95% CI: 1.008-1.028, P = 0.001], nighttime diastolic BP level (HR = 1.024, 95% CI: 1.007-1.042, P = 0.007), nocturnal hypertension (HR = 1.688, 95% CI: 1.229-2.317, P = 0.001) were associated with HF rehospitalization. Kaplan-Meier analysis had demonstrated that patients with nocturnal hypertension had significantly lower event-free survival rate (log-rank P < 0.001). Furthermore, patients with a riser pattern had a higher risk of HF rehospitalization (HR = 1.828, 95% CI: 1.055-3.166, P = 0.031) and lower event-free survival rate (log-rank P = 0.003) than those with a dipper pattern. These findings were also confirmed in patients with HFpEF and hyperuricemia. CONCLUSIONS Nighttime BP levels, nocturnal hypertension and a riser pattern are independently associated with HF rehospitalization in patients with HFpEF, and prominently in patients with HFpEF and hyperuricemia. Well controlled nighttime BP levels should be emphasized and considered in patients with HFpEF."

基金机构："Department of Human Resources and Social Security of Sichuan Province; Chengdu Municipal Health Commission [2021200, 2022392]; Science and Technology Bureau of Chengdu [2019-YF05-00523-SN]; Fundamental Research Funds for the Central Universities [2682022ZTPY029, 2682021ZTPY026]"

基金资助正文："This study was supported by the Department of Human Resources and Social Security of Sichuan Province (No.2021-11), the Chengdu Municipal Health Commission (No.2021200 & No.2022392), the Science and Technology Bureau of Chengdu (2019-YF05-00523-SN), and the Fundamental Research Funds for the Central Universities (No.2682022ZTPY029 & No.2682021ZTPY026). All authors had no conflicts of interest to disclose."