The Relationship between Nocturnal Dipping Status, Morning Blood Pressure Surge, and Hospital Admissions in Patients with Systolic Heart Failure
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Date
2023
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Abstract
Background: Hypertension is a known risk factor for developing heart failure. However, there is limited data to investigate the association between morning blood pressure surge (MBPS), dipping status, echocardiographic parameters, and hospital admissions in patients with systolic heart failure. Objectives: To evaluate the relationship between morning blood pressure surge, non-dipper blood pressure pattern, echocardiographic parameters, and hospital admissions in patients with systolic heart failure. Methods: We retrospectively analyzed data from 206 consecutive patients with hypertension and a left ventricular ejection fraction below 40%. We divided the patients into two groups according to 24-hour ambulatory blood pressure monitoring (ABPM) results: dippers (n=110) and non-dippers (n=96). Morning blood pressure surge was calculated. Echocardiographic findings and hospital admissions during follow-up were noted. Statistical significance was defined as p < 0.05. Results: The study group comprised 206 patients with a male predominance and mean age of 63.5 ± 16.1 years. The non-dipper group had significantly more hospital admissions compared to dippers. There was a positive correlation between MBPS and left atrial volume index (r=0.331, p=0.001), the ratio between early mitral inflow velocity and flow propagation velocity (r= 0.326, p=0.001), and the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/Em) (r= 0.314, p=0.001). Non-dipper BP, MBPS, and E/Em pattern were found to be independently associated with increased hospital admissions. Conclusion: MBPS is associated with diastolic dysfunction and may be a sensitive predictor of hospital admission in patients with systolic heart failure. © 2023, Sociedade Brasileira de Cardiologia. All rights reserved.
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Aged , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Female , Heart Failure, Systolic , Hospitals , Humans , Hypertension , Male , Middle Aged , Retrospective Studies , Stroke Volume , Ventricular Function, Left , beta adrenergic receptor blocking agent , brain natriuretic peptide , diuretic agent , adult , arterial pressure , Article , blood pressure , blood pressure monitoring , chronic kidney failure , chronic obstructive lung disease , diabetes mellitus , diastolic blood pressure , diastolic dysfunction , echocardiography , end-diastolic velocity , heart ejection fraction , heart left ventricle ejection fraction , human , hypertension , male , receiver operating characteristic , relaxation time , retrospective study , risk factor , statistical significance , systolic blood pressure , systolic heart failure , velocity , aged , blood pressure monitoring , complication , diagnostic imaging , female , heart left ventricle function , heart stroke volume , hospital , hypertension , middle aged