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Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure

AIMS: Data regarding the optimal systolic blood pressure (SBP) and heart rate (HR) for coronary artery disease (CAD) patients with hypertension and a history of heart failure (HF) are limited. Accordingly, using data from a large clinical trial, we investigated the association between SBP and heart...

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Autores principales: Elgendy, Islam Y., Hill, James A., Szady, Anita D., Gong, Yan, Cooper‐DeHoff, Rhonda M., Pepine, Carl J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083485/
https://www.ncbi.nlm.nih.gov/pubmed/31840441
http://dx.doi.org/10.1002/ehf2.12534
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author Elgendy, Islam Y.
Hill, James A.
Szady, Anita D.
Gong, Yan
Cooper‐DeHoff, Rhonda M.
Pepine, Carl J.
author_facet Elgendy, Islam Y.
Hill, James A.
Szady, Anita D.
Gong, Yan
Cooper‐DeHoff, Rhonda M.
Pepine, Carl J.
author_sort Elgendy, Islam Y.
collection PubMed
description AIMS: Data regarding the optimal systolic blood pressure (SBP) and heart rate (HR) for coronary artery disease (CAD) patients with hypertension and a history of heart failure (HF) are limited. Accordingly, using data from a large clinical trial, we investigated the association between SBP and heart rate and subsequent adverse outcomes in CAD patients with a history of HF, and we aimed to better understand how pre‐existing HF impacts outcomes among patients with CAD. METHODS AND RESULTS: Among 22 576 CAD patients enrolled in the INternational VErapamil SR‐Trandolapril STudy (INVEST), 1256 were identified with a history of physician‐diagnosed HF New York Heart Association (NYHA) Class 1–3 at entry. The primary outcome was the first occurrence of all‐cause death, myocardial infarction (MI), or stroke. Cox proportional‐hazards models adjusted for pre‐specified covariates were constructed to estimate risk among the HF cohort compared with a case‐matched sample from the non‐HF cohort. At a mean 2.5 years' follow‐up, those with prior HF had a higher risk of the primary outcome (hazard ratio (HR) 2.55, 95% confidence interval 2.30–2.83, P < 0.0001). Among those with history of HF, a low (<120 mmHg) or high (>140 mmHg) SBP and heart rate ≥ 85 b.p.m. were associated with increased risk for adverse outcomes, which persisted after covariate adjustment. CONCLUSIONS: In patients with CAD, a physician diagnosis of HF at baseline portended a higher risk for death, MI, or stroke than in those without an HF history. Achieving SBP of 120–140 mmHg and heart rate < 85 b.p.m. was associated with a better outcome in patients with known HF and CAD.
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spelling pubmed-70834852020-03-24 Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure Elgendy, Islam Y. Hill, James A. Szady, Anita D. Gong, Yan Cooper‐DeHoff, Rhonda M. Pepine, Carl J. ESC Heart Fail Original Research Articles AIMS: Data regarding the optimal systolic blood pressure (SBP) and heart rate (HR) for coronary artery disease (CAD) patients with hypertension and a history of heart failure (HF) are limited. Accordingly, using data from a large clinical trial, we investigated the association between SBP and heart rate and subsequent adverse outcomes in CAD patients with a history of HF, and we aimed to better understand how pre‐existing HF impacts outcomes among patients with CAD. METHODS AND RESULTS: Among 22 576 CAD patients enrolled in the INternational VErapamil SR‐Trandolapril STudy (INVEST), 1256 were identified with a history of physician‐diagnosed HF New York Heart Association (NYHA) Class 1–3 at entry. The primary outcome was the first occurrence of all‐cause death, myocardial infarction (MI), or stroke. Cox proportional‐hazards models adjusted for pre‐specified covariates were constructed to estimate risk among the HF cohort compared with a case‐matched sample from the non‐HF cohort. At a mean 2.5 years' follow‐up, those with prior HF had a higher risk of the primary outcome (hazard ratio (HR) 2.55, 95% confidence interval 2.30–2.83, P < 0.0001). Among those with history of HF, a low (<120 mmHg) or high (>140 mmHg) SBP and heart rate ≥ 85 b.p.m. were associated with increased risk for adverse outcomes, which persisted after covariate adjustment. CONCLUSIONS: In patients with CAD, a physician diagnosis of HF at baseline portended a higher risk for death, MI, or stroke than in those without an HF history. Achieving SBP of 120–140 mmHg and heart rate < 85 b.p.m. was associated with a better outcome in patients with known HF and CAD. John Wiley and Sons Inc. 2019-12-15 /pmc/articles/PMC7083485/ /pubmed/31840441 http://dx.doi.org/10.1002/ehf2.12534 Text en © 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research Articles
Elgendy, Islam Y.
Hill, James A.
Szady, Anita D.
Gong, Yan
Cooper‐DeHoff, Rhonda M.
Pepine, Carl J.
Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
title Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
title_full Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
title_fullStr Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
title_full_unstemmed Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
title_short Systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
title_sort systolic blood pressure, heart rate, and outcomes in patients with coronary disease and heart failure
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083485/
https://www.ncbi.nlm.nih.gov/pubmed/31840441
http://dx.doi.org/10.1002/ehf2.12534
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