title: Influence of blood pressure at the beginning of decompensations in the prognosis of patients with heart failure.
abstract: OBJECTIVE
  An inverse relationship has been described between blood pressure and the prognosis in heart failure (HF). The characteristics of this relationship are not well unknown. The objective of this study was to determine if this relationship is maintained in a non-selected cohort of patients with HF and if it can be modified by treatment.
  
  
  METHODS
  Prospective study of cohorts including patients hospitalized for decompensated HF in Internal Medicine departments and followed as outpatients in a monographic consultation. Patients were classified according to their levels of systolic (SBP) and diastolic blood pressure (DBP). Clinical characteristics, all-cause mortality and readmissions after the first, third and sixth month of follow-up were analysed.
  
  
  RESULTS
  Two hundred and twenty-one patients were included after their admission to the hospital for acute HF. Mean patient age was 79.5 years(SD 8.09); 115 patients were male. No significant differences between SBP quartiles and basal characteristics were found. Patients with lower SBP (Q1) had higher mortality rates (20%, P<.05). No significant differences between mortality/readmissions and DBP were found. However, the Kaplan-Meier analysis showed higher all-cause mortality rates for the group of patients with lower SBP and DBP (log-rank=0.011 and 0.041, respectively). The pharmacological treatment did not differ significantly between both study groups.
  
  
  CONCLUSIONS
  For non-selected patients suffering HF, higher SBP upon the admission is associated with significantly lower all-cause mortality rates during follow-up. Pharmacological treatment of HF does not seem to influence this inverse relationship between SBP at admission and patient mortality.
authors.affiliation: Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España. Electronic address: siltorrenteir@gmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Torrente Iranzo
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Garcés Horna
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
authors.forename: Claudia
authors.initials: C
authors.lastname: Josa Laorden
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rubio Gracia
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
authors.forename: Fernando José
authors.initials: FJ
authors.lastname: Ruiz Laiglesia
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Sánchez Marteles
authors.affiliation: Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España; Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón, Zaragoza, España.
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Pérez Calvo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
keywords: Blood pressure; Epidemiología reversa; Heart failure; Insuficiencia cardiaca; Presión arterial; Reverse epidemiology