A Historical Perspective on Presentations of Hypertensive Acute Heart Failure
Authors
Darling, Chad E.Sun, Jiaoyuan Elisabeth
Goldberg, Jordan
Pang, Peter
Baugh, Christopher W.
Lessard, Darleen M.
McManus, David D.
UMass Chan Affiliations
Department of Quantitative Health SciencesDepartment of Medicine, Division of Cardiovascular Medicine
Department of Emergency Medicine
Document Type
Journal ArticlePublication Date
2017-05-15Keywords
Acute heart failureemergency department
epidemiology
systolic blood pressure
Cardiology
Cardiovascular Diseases
Emergency Medicine
Metadata
Show full item recordAbstract
BACKGROUND: The initial systolic blood pressure (SBP) in patients presenting to the hospital with acute heart failure (AHF) informs prognosis, diagnosis, and guides initial treatment. However, over time AHF presentations with elevated SBP appear to have declined. The present study examined whether the frequency of AHF presentations with systolic hypertension (SBP > 160 mmHg) declined over a nearly two-decade time interval. METHODS: This study compares four historical, cross-sectional cohorts with AHF who were admitted to tertiary care medical centres in the North-eastern USA in 1995, 2000, 2006, and 2011-13. The main outcome was the proportion of AHF patients presenting with an initial SBP > 160 mmHg. RESULTS: 2,366 patients comprised the study sample. The average age was 77 years, 55% were female, 94% white, and 75% had prior heart failure. In 1995, 34% of AHF patients presented with an initial SBP > 160 mmHg compared to 20% in 2011-2013 (p < 0.01). Multivariate logistic regression demonstrated reduced odds of presenting with a SBP > 160 mmHg in 2006 (0.64, 95% CI 0.42-0.96) and 2011-13 (0.46, 95% CI 0.28-0.74) compared with patients in 1995. CONCLUSION: The proportion of patients with AHF and initial SBP > 160 mmHg significantly declined over the study time period. There are several potential reasons for this observation and these findings highlight the need for ongoing surveillance of patients with AHF as changing clinical characteristics can impact early treatment decisions.Source
J Cardiovasc Dis Diagn. 2017 May;5(3). pii: 275. doi: 10.4172/2329-9517.1000275. Epub 2017 May 15. Link to article on publisher's siteDOI
10.4172/2329-9517.1000275Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28547PubMed ID
28824930Related Resources
Link to Article in PubMedRights
Copyright: © 2017 Darling CE, et al.Distribution License
http://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.4172/2329-9517.1000275
Scopus Count
Except where otherwise noted, this item's license is described as Copyright: © 2017 Darling CE, et al.