Please use this identifier to cite or link to this item:
doi:10.22028/D291-41559
Title: | Associations between baseline heart rate and blood pressure and time to events in heart failure with reduced ejection fraction patients: Data from the QUALIFY international registry |
Author(s): | Abdin, Amr Anker, Stefan D. Cowie, Martin R. Filippatos, Gerasimos S. Ponikowski, Piotr Tavazzi, Luigi Schöpe, Jakob Wagenpfeil, Stefan Komajda, Michel Böhm, Michael |
Language: | English |
Title: | European Journal of Heart Failure |
Volume: | 25 |
Issue: | 11 |
Pages: | 1985-1993 |
Publisher/Platform: | Wiley |
Year of Publication: | 2023 |
Free key words: | Heart failure Resting heart rate Systolic blood pressure Outcome Treatment |
DDC notations: | 610 Medicine and health |
Publikation type: | Journal Article |
Abstract: | Aims A high resting heart rate (RHR) and low systolic blood pressure (SBP) are a risk factor and a risk indicator, respectively, for poor heart failure (HF) outcomes. This analysis evaluated the associations between baseline RHR and SBP with outcomes and treatment patterns in patients with HF and reduced ejection fraction (HFrEF) in the QUALIFY (QUality of Adherence to guideline recommendations for LIFe-saving treatment in heart failure surveY) international registry. Methods and results Between September 2013 and December 2014, 7317 HFrEF patients with a previous HF hospitalization within 1–15 months were enrolled in the QUALIFY registry. Complete follow-up data were available for 5138 patients. The relationships between RHR and SBP and outcomes were assessed using a Cox proportional hazards model and were analysed according to baseline values as high RHR (H-RHR) ≥75 bpm versus low RHR (L-RHR) <75 bpm and high SBP (H-SBP) ≥110 mmHg versus low SBP (L-SBP) <110 mmHg and analysed according to each of the following four phenotypes: H-RHR/L-SBP, L-RHR/L-SBP, H-RHR/H-SBP and L-RHR/H-SBP (reference group). Compared to the reference group, H-RHR/L-SBP was associated with the worst outcomes for the combined primary endpoint of cardiovascular death and HF hospitalization (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.51–2.21, p < 0.001), cardiovascular death (HR 2.70, 95% CI 1.69–4.33, p < 0.001), and HF hospitalization (HR 1.62, 95% CI 1.30–2.01, p < 0.001). Low-risk patients with L-RHR/H-SBP achieved more frequently ≥50% of target doses of angiotensin-converting enzyme inhibitors (ACEIs) and beta-blockers (BBs) than the other groups. However, 48% and 46% of low-risk patients were not well treated with ACEIs and BBs, respectively (≤50% of target dose or no treatment). Conclusion In patients with HFrEF and recent hospitalization, elevated RHR and lower SBP identify patients at increased risk for cardiovascular endpoints. While SBP and RHR are often recognized as barriers that deter physicians from treating with high doses of recommended drugs, they are not the only reason leaving many patients suboptimally treated. |
DOI of the first publication: | 10.1002/ejhf.3023 |
URL of the first publication: | https://onlinelibrary.wiley.com/doi/10.1002/ejhf.3023 |
Link to this record: | urn:nbn:de:bsz:291--ds-415599 hdl:20.500.11880/37247 http://dx.doi.org/10.22028/D291-41559 |
ISSN: | 1879-0844 1388-9842 |
Date of registration: | 5-Feb-2024 |
Description of the related object: | Supporting Information |
Related object: | https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Fejhf.3023&file=ejhf3023-sup-0001-supinfo.docx |
Faculty: | M - Medizinische Fakultät |
Department: | M - Innere Medizin M - Medizinische Biometrie, Epidemiologie und medizinische Informatik |
Professorship: | M - Prof. Dr. Michael Böhm M - Prof. Dr. Stefan Wagenpfeil |
Collections: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
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File | Description | Size | Format | |
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European J of Heart Fail - 2023 - Abdin - Associations between baseline heart rate and blood pressure and time to events in.pdf | 1,57 MB | Adobe PDF | View/Open |
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