Nocturnal hypertension and riser pattern are associated with heart failure rehospitalization in patients with heart failure with preserved ejection fraction
Gang HUANG1
Xiao-Han LIU2
Yue ZHANG2
Yu-Xin ZHU2
Yun HE1
Tian-Bo WANG2
Zhen ZHANG1
Jun-Bo XU1
1.Department of Cardiology,the Third People's Hospital of Chengdu,Sichuan,China;Cardiovascular Disease Research Institute of Chengdu,Sichuan,China;Affiliated Hospital of Southwest Jiaotong University,Sichuan,China;The Seco-nd Affiliated Chengdu Clinical College of Chongqing Medical University,Sichuan,China2.Affiliated Hospital of Southwest Jiaotong University,Sichuan,China
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 asso-ciation 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 hyper-tension(HR=1.688,95％CI:1.229-2.317,P=0.001)were associated with HF rehospitalization.Kaplan-Meier analysis had demonst-rated 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 rehos-pitalization 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.
机标关键词：hypertensionfractionheartwithrehoassociatedejectionfailure
论文发表日期：2023-06-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：11( 448-458 )