title: Ambulatory Blood Pressure Parameters and Heart Failure With Reduced or Preserved Ejection Fraction in Elderly Treated Hypertensive Patients.
abstract: The association between ambulatory blood pressure (BP) and future risk of heart failure (HF) is unclear. We investigated the association between ambulatory BP parameters and risk of HF with reduced ejection fraction (HFREF) or preserved ejection fraction (HFPEF) in elderly treated hypertensive patients.
  
  
  
  The occurrence of HFREF and HFPEF was evaluated in 1,191 elderly treated hypertensive patients who underwent clinical and instrumental evaluation, including ambulatory BP monitoring to evaluate daytime, nighttime, and 24-hour BP, dipping status, and morning surge (MS) of BP.
  
  
  
  During the follow-up (9.1±4.9 years, range 0.4-20 years), 123 patients developed HF, of whom 56 had HFREF and 67 had HFPEF. After adjustment for other covariates, Cox regression analysis showed that 24-hour systolic BP, but not clinic BP, was independently associated with risk of both HFREF (hazard ratio (HR): 1.36, 95% confidence interval (CI): 1.14-1.63, per 10mm Hg increment) and HFPEF (HR: 1.35, 95% CI: 1.13-1.61, per 10mm Hg increment); moreover, high MS of BP (>23mm Hg) in dippers was independently associated with risk of HFREF (HR: 2.27, 95% CI: 1.00-5.15) and nondipping was independently associated with risk of HFPEF (HR: 2.78, 95% CI: 1.38-5.63).
  
  
  
  In elderly treated hypertensive patients, 24-hour systolic BP is independently associated with future risk of both HFREF and HFPEF, whereas high MS is independently associated with risk of HFREF and nondipping is independently associated with risk of HFPEF.
authors.affiliation: Dipartimento di Scienze Mediche, Orali e Biotecnologiche, Università "Gabriele d'Annunzio", Chieti, Italy; Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy; pierdomenico@unich.it.
authors.forename: Sante D
authors.initials: SD
authors.lastname: Pierdomenico
authors.affiliation: Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy; Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pierdomenico
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Coccina
authors.affiliation: Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy; Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Lapenna
authors.affiliation: Centro di Ricerca Clinica, Fondazione Università "Gabriele d'Annunzio", Chieti, Italy; Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Porreca
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume
keywords: ambulatory blood pressure; dippers; heart failure; hypertension; morning surge; nondippers.