Abstract：
BACKGROUND:Disease-modifying drug treatment in heart failure (HF) reduces blood pressure. Titration of these agents is guided by clinic blood pressure readings; however, the impact of such treatment on blood pressure is unknown because diurnal blood pressure patterns remain poorly described. The aim of this study was to examine the impact of additional neurohumoral modulating agents on ambulatory blood pressure monitoring (ABPM) control in patients with systolic HF and examine the relationship between the burden of hypotension and clinical outcomes. METHODS AND RESULTS:In a prospective analysis on 45 patients undergoing initiation and optimization of additional medications (angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or beta-blockers), mean daytime systolic (P = .035) and mean daytime and nocturnal diastolic hypotensive episodes (both P < .001) increased significantly posttitration. There was no change in clinic blood pressure before and after titration. In a cross-sectional analysis on 144 patients, those with the most diastolic hypotensive episodes had higher rates of HF readmissions (P = .01) and the composite end point of all-cause mortality and all-cause readmissions (P = .03). CONCLUSIONS:Additional neurohumoral modulating agents could produce significant increases in 24-hour hypotension burden despite reassuring clinic blood pressure readings. The burden of diastolic hypotension is independently predictive of HF readmissions and the composite end point of all-cause mortality and emergency readmissions.
journal_name
J Card Failjournal_title
Journal of cardiac failureauthors
Mak G,Murphy NF,Ali A,Walsh A,O'Loughlin C,Conlon C,McCaffrey D,Ledwidge M,McDonald Kdoi
10.1016/j.cardfail.2008.03.003subject
Has Abstractpub_date
2008-09-01 00:00:00pages
555-60issue
7eissn
1071-9164issn
1532-8414pii
S1071-9164(08)00102-4journal_volume
14pub_type
杂志文章abstract：:Heart failure (HF) is a syndrome characterized by high mortality, frequent hospitalization, reduced quality of life, and a complex therapeutic regimen. Knowledge about HF is accumulating so rapidly that individual clinicians may be unable to readily and adequately synthesize new information into effective strategies o...
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journal_title：Journal of cardiac failure
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journal_title：Journal of cardiac failure
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pub_type： 杂志文章,meta分析,评审
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journal_title：Journal of cardiac failure
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journal_title：Journal of cardiac failure
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of cardiac failure
pub_type： 临床试验,杂志文章,随机对照试验
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pub_type： 杂志文章
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journal_title：Journal of cardiac failure
pub_type： 杂志文章
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更新日期：2020-09-01 00:00:00
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journal_title：Journal of cardiac failure
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journal_title：Journal of cardiac failure
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journal_title：Journal of cardiac failure
pub_type： 杂志文章,多中心研究,随机对照试验
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journal_title：Journal of cardiac failure
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