The association between admission systolic blood pressure of heart failure patients with preserved systolic function and mortality outcomes

Introduction Heart failure is a major cause of death and disability and poses a significant public health concern. Approximately half of the patients admitted with heart failure, have preserved left ventricular ejection fraction. The association between systolic blood pressure (SBP) and long-term outcome in this group has not been well established. Aim The aim of our study is to evaluate the association between admission SBP and short term and long-term mortality outcomes in patients with heart failure and preserved systolic function. Methods 1230 consecutive patients presenting with preserved left ventricular (LV) systolic function (defined as an LV ejection fraction ≥ 40%) were included in this survey. Patients were divided into quartiles according to admission SBP: low admission SBP (< 127 mm Hg), intermediate admission SBP (128-145 mm Hg), high admission SBP (146-170 mm Hg) and very-high admission SBP (> 170 mm Hg). Primary outcome included in hospital, one and four year mortality rates. Results Elevated admission SBP was found to be associated with improved short and long-term mortality (HR = 0.25 95% CI - 0.09-0.7, p = 0.007 and HR = 0.7 95% CI - 0.56-0.88, p = 0.002 for the highest versus low SBP group, respectively). This finding was most notable in patients with acute heart failure and patients with ejection fraction ≥ 50%. Conclusion Elevated admission SBP is associated with a favorable short and long-term outcome in patients with heart failure and preserved systolic function. Key message Low admission SBP is an independent predictor for short and long-term mortality in patients with HF and PSF.