BACKGROUND Nocturnal hypertension is reported as a risk factor for cardiovascular disease.This study aimed to explore the potential association between nocturnal hypertension and heart failure(HF)rehospitalization in ...BACKGROUND Nocturnal hypertension is reported as a risk factor for cardiovascular disease.This study aimed to explore the potential association between nocturnal hypertension and heart failure(HF)rehospitalization in patients with HF with preserved ejection fraction(HFpEF).METHODS A total of 538 patients with HFpEF from May 2018 to December 2021 were consequently recruited in this study and followed up until they were readmitted for HF or the end of this study.Cox regression analysis was used to reveal the potential association between nighttime blood pressure(BP)levels,nocturnal hypertension and nocturnal BP patterns and HF rehospitalization.Kaplan-Meier curve was used to assess the cumulative event-free survival rate between groups.RESULTS There were 537 patients with HFpEF were included in the final analysis.The mean age of the study population was 77.14±8.68 years,and 41.2% of patients were men.After a median follow-up duration of 10.93(4.19–21.13)months,176 patients(32.7%)with HFpEF were readmitted for HF.Cox regression analysis had revealed that nighttime systolic BP level[hazards ratio(HR)=1.018,95%CI:1.008–1.028,P=0.001],nighttime diastolic BP level(HR=1.024,95%CI:1.007–1.042,P=0.007),nocturnal hypertension(HR=1.688,95%CI:1.229–2.317,P=0.001)were associated with HF rehospitalization.Kaplan-Meier analysis had demonstrated that patients with nocturnal hypertension had significantly lower event-free survival rate(log-rank P<0.001).Furthermore,patients with a riser pattern had a higher risk of HF rehospitalization(HR=1.828,95%CI:1.055–3.166,P=0.031)and lower eventfree survival rate(log-rank P=0.003)than those with a dipper pattern.These findings were also confirmed in patients with HFpEF and hyperuricemia.CONCLUSIONS Nighttime BP levels,nocturnal hypertension and a riser pattern are independently associated with HF rehospitalization in patients with HFpEF,and prominently in patients with HFpEF and hyperuricemia.Well controlled nighttime BP levels should be emphasized and considered in patients with HFpEF.展开更多
基金This study was supported by the Department of Human Resources and Social Security of Sichuan Province(No.2021-11)the Chengdu Municipal Health Commission(No.2021200&No.2022392)+1 种基金the Science and Technology Bureau of Chengdu(2019-YF05-00523-SN)the Fundamental Research Funds for the Central Universities(No.2682022ZTPY029&No.2682021ZTPY026).
文摘BACKGROUND Nocturnal hypertension is reported as a risk factor for cardiovascular disease.This study aimed to explore the potential association between nocturnal hypertension and heart failure(HF)rehospitalization in patients with HF with preserved ejection fraction(HFpEF).METHODS A total of 538 patients with HFpEF from May 2018 to December 2021 were consequently recruited in this study and followed up until they were readmitted for HF or the end of this study.Cox regression analysis was used to reveal the potential association between nighttime blood pressure(BP)levels,nocturnal hypertension and nocturnal BP patterns and HF rehospitalization.Kaplan-Meier curve was used to assess the cumulative event-free survival rate between groups.RESULTS There were 537 patients with HFpEF were included in the final analysis.The mean age of the study population was 77.14±8.68 years,and 41.2% of patients were men.After a median follow-up duration of 10.93(4.19–21.13)months,176 patients(32.7%)with HFpEF were readmitted for HF.Cox regression analysis had revealed that nighttime systolic BP level[hazards ratio(HR)=1.018,95%CI:1.008–1.028,P=0.001],nighttime diastolic BP level(HR=1.024,95%CI:1.007–1.042,P=0.007),nocturnal hypertension(HR=1.688,95%CI:1.229–2.317,P=0.001)were associated with HF rehospitalization.Kaplan-Meier analysis had demonstrated that patients with nocturnal hypertension had significantly lower event-free survival rate(log-rank P<0.001).Furthermore,patients with a riser pattern had a higher risk of HF rehospitalization(HR=1.828,95%CI:1.055–3.166,P=0.031)and lower eventfree survival rate(log-rank P=0.003)than those with a dipper pattern.These findings were also confirmed in patients with HFpEF and hyperuricemia.CONCLUSIONS Nighttime BP levels,nocturnal hypertension and a riser pattern are independently associated with HF rehospitalization in patients with HFpEF,and prominently in patients with HFpEF and hyperuricemia.Well controlled nighttime BP levels should be emphasized and considered in patients with HFpEF.