Abstract 13655: The Prevalence and Prognosis of Resistant Hypertension in Heart Failure Patients With Reduced or Preserved Ejection Fraction
Purpose: The clinical impact of resistant hypertension (RHTN) in heart failure (HF) patients is poorly understood. We sought to determine the prevalence and prognosis of RHTN in hypertensive HF patients.
Methods: Consecutive patients admitted to a tertiary teaching hospital for HF with a prior history of hypertension were prospectively enrolled. Patients were divided into 2 groups: HF with reduced EF (HFrEF) (EF<50%) and HF with preserved EF (HFpEF) (EF≥50%). RHTN was defined as blood pressure ≥140/90mmHg (≥130/80mmHg if diabetes/chronic kidney diease) with the use of ≥3 antihypertensive medications, including a diuretic, after the index HF hospitalization. Cardiovascular outcomes were defined as all-cause mortality, cardiovascular mortality and HF rehospitalization within 1 year follow-up.
Results: A total of 939 patients were studied (age=77.6±10.4 years, 555 female, EF=52.5%±15.2%). The prevalence of RHTN in HFrEF (n=352) and HFpEF (n=587) were 17.3% and 19.9%, respectively (P=0.325). 1 year All-cause (30.1% vs. 19.3%, P<0.001) and cardiovascular mortality (20.1% vs. 12.3%, P<0.001) were significantly higher in HFrEF vs. HFpEF patients. There was no difference in all-cause mortality and cardiovascular mortality for patients with vs. without RHTN in both HFpEF group and HFrEF group. In HFrEF but not HFpEF group, HF rehospitalization was lower in patients with RHTN (27.9% vs. 41.2%, P=0.052) although not statistically significant (Table).
Conclusions: The prevalence of RHTN was high in patients with HFrEF and HFpEF but appears not associated with adverse long-term clinical outcome. This may have implication in the target blood pressure for treating hypertension in the HF population.
- © 2013 by American Heart Association, Inc.