Acute heart failure associated with high admission blood pressure--a distinct vascular disorder?

Journal Article (Journal Article)

BACKGROUND: Although blood pressure (BP) is elevated in patients with acute heart failure (AHF), first admission BP has not been meticulously recorded before treatment in previous studies. METHODS: During three consecutive months, all AHF admissions (335 patients) to a city hospital which provides the sole inpatient medical service for approximately 500,000 people were registered. First BP was recorded before treatment at the first patient encounter in the ambulance or the emergency room. RESULTS: Mean BP at admission was 164+/-38/88+/-22 mm Hg. Mean BP in the highest quartile was 212+/-22/115+/-13 mm Hg. Patients with higher baseline BP had higher ejection fraction (highest versus lowest quartile 48+/-13% vs. 33+/-14%, p<0.001), less atrial fibrillation (18% vs. 42%, p=0.001) as well as lower mean urea and higher mean haemoglobin. The apparently more favourable baseline characteristics in patients with higher admission BP did not translate into lower morbidity - the rate of worsening heart failure - was not related to admission BP. However, 6 month mortality was lower in patients with higher admission BP (4% vs. 19.3%, p=0.002). CONCLUSIONS: Blood pressure is elevated substantially at the onset of AHF. The different characteristics and outcome of patients admitted with high-BP associated AHF suggest that this presentation may be a specific disorder related to a distinct yet unknown pathophysiological mechanism.

Full Text

Duke Authors

Cited Authors

  • Milo-Cotter, O; Adams, KF; O'Connor, CM; Uriel, N; Kaluski, E; Felker, GM; Weatherley, B; Vered, Z; Cotter, G

Published Date

  • February 2007

Published In

Volume / Issue

  • 9 / 2

Start / End Page

  • 178 - 183

PubMed ID

  • 16877039

International Standard Serial Number (ISSN)

  • 1388-9842

Digital Object Identifier (DOI)

  • 10.1016/j.ejheart.2006.06.004


  • eng

Conference Location

  • England