Utilidad pronóstica de las cifras ambulatorias de presión arterial en pacientes de edad avanzada con insuficiencia cardíaca. Resultados del estudio DICUMAP = Prognostic value of ambulatory blood pressure values in elderly patients with heart failure. Results of the DICUMAP study

Camafort, M., Jhund, P. S. , Formiga, F., Castro- Salomó, A., Arévalo-Lorido, J. C., Sobrino-Martínez, J., Manzano, L., Diez-Manglano, J., Aramburu, O. and Pérez-Barquero, M. M. (2021) Utilidad pronóstica de las cifras ambulatorias de presión arterial en pacientes de edad avanzada con insuficiencia cardíaca. Resultados del estudio DICUMAP = Prognostic value of ambulatory blood pressure values in elderly patients with heart failure. Results of the DICUMAP study. Revista Clínica Española, 221(8), pp. 433-440. (doi: 10.1016/j.rce.2020.11.010)

Abstract

Introduction: Ambulatory blood pressure monitoring (ABPM) has demonstrated value in the prognostic assessment of hypertensive patients with heart failure (HF) with or without other cardiovascular diseases. The objective of this study was to evaluate whether ABPM can identify subjects with HF with a worse prognosis. Methods and results: Prospective multicenter study that included clinically stable outpatients with HF. All patients underwent ABPM. A total of 154 patients from 17 centers were included. Their mean age was 76.8 years (± 8.3) and 55.2% were female. In total, 23.7% had HF with a reduced ejection fraction (HFrEF), 68.2% were in NYHA functional class II, and 19.5% were in NYHA functional class III. At one year of follow up, there were 13 (8.4%) deaths, of which 10 were attributed to HF. Twenty-nine patients required hospitalization, of which 19 were due to HF. The presence of a non-dipper BP pattern was associated with an increased risk for readmission or death at one year of follow-up (25% vs. 5%; p = .024). According to a Cox regression analysis, more advanced NYHA functional class (hazard ratio 3.51; 95%CI 1.70-7.26; p = .001; for NYHA class III vs. II) and a higher proportional nocturnal reduction in diastolic BP (hazard ratio 0.961; 95%CI 0.926-0.997; p = .032 per 1% diastolic BP reduction) were independently associated with death or readmission at one year. Conclusion: In older patients with chronic HF, a non-dipper BP pattern measured by ABPM was associated with a higher risk of hospitalization and death due to HF.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jhund, Professor Pardeep
• Authors: Camafort, M., Jhund, P. S., Formiga, F., Castro- Salomó, A., Arévalo-Lorido, J. C., Sobrino-Martínez, J., Manzano, L., Diez-Manglano, J., Aramburu, O., and Pérez-Barquero, M. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Revista Clínica Española
• Publisher: Elsevier
• ISSN: 0014-2565
• ISSN (Online): 1578-1860
• Published Online: 16 April 2021
• Copyright Holders: Copyright © 2021 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)
• First Published: First published in Revista Clínica Española 221(8): 433-440
• Publisher Policy: Reproduced in accordance with the publisher copyright policy