Cardiology Letters 2012, 21(4):288-294

Influence of age, blood pressure, body mass index, laboratory parameters and left ventricular ejection fraction on in-hospital mortality of patients with hypertension and acute heart failure

Felšöci M^{1, 2}, Pařenica J^{1, 2, 3}, Miklík R^{1, 2, 3}, Jarkovský J⁴, Špinar J^{1, 2, 3}

¹ Interní kardiologické klinika Fakultní nemocnice Brno

² Lékařské fakulta Masarykovy univerzita Brno

³ Mezinárodní centrum klinického výzkumu, Fakultní nemocnice u sv. Anny v Brně

⁴ Institut biostatistiky a analýz Masarykovy univerzita v Brně, Česká republika

Purpose: Whether generally accepted predictors of in-hospital mortality in patients with acute heart failure (HF) are effective, also in the sub-population with previous hypertension is unclear.

Methods: We used patient data from the single university centre that is participating in the Czech HF registry. Within the study period of December 2004 and August 2007 we enrolled 1253 patients with acute HF. After the selection of those with previous hypertension, we tested the influence of age, body mass index (BMI), laboratory parameters, the level of blood pressure (BP) on admission and left ventricular ejection fraction (LVEF) on in-hospital mortality.

Results: In-hospital mortality of patients with acute HF and hypertension (n=843, 67%) was 14.0% with the mean length of hospital stay 6.9 days. Patients deceased during hospitalisation were older, with lower haemoglobin level, higher entry and maximal serum creatinine, glycaemia and C-reactive protein (CRP), lower BMI, entry BP and LVEF. In univariate analysis in-hospital mortality was worsened by age [odds ratio (OR) 1.28], BP < 120/80 mmHg at entry (OR 6.40), LVEF ≤ 20% (OR 2.09), increasing creatinine level (OR 1.29), glycaemia (OR 2.75) or CRP (OR 1.10) and by the positivity of troponin (OR 2.04). A protective influence was found in patients with BMI > 25 kg/m2 (OR 0.48), LVEF ≥ 41% (OR 0.41), entry BP ≥ 140/90 mmHg (OR 0.40) with positive influence even in patients with BP ≥ 180/110 mmHg (OR 0.34).

Conclusion: In-hospital mortality of patients with acute HF and previous hypertension is associated with several factors. Probably the most important of these is low blood pressure at admission.

Keywords: hypertension; acute heart failure; in-hospital mortality

Published: April 1, 2012  Show citation