Diastolic Blood Pressure and Adverse Outcomes in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) Trial

Journal of the American Heart Association
Pratik SandesaraLaurence S Sperling

Abstract

Although diastolic blood pressure (DBP) is independently associated with an increased risk of adverse cardiovascular outcomes in the general population, it is unclear if a similar relationship exists in patients with heart failure with preserved ejection fraction. This analysis included 1703 (mean age, 72±10 years; 50% men; 78% white) patients with heart failure with preserved ejection fraction enrolled in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) Trial from the Americas who were treated for hypertension. Multivariable Cox regression was used to examine the risk of hospitalization for heart failure, death, and cardiovascular death associated with DBP. The relationship between hospitalization for heart failure and DBP was linear, with an increased risk observed with decreasing DBP values (≥90 mm Hg: referent; 80-89 mm Hg: hazard ratio [HR], 1.44; 95% confidence interval [CI], 0.85-2.44; 70-79 mm Hg: HR, 1.18; 95% CI, 0.69-2.01; 60-69 mm Hg: HR, 1.54; 95% CI, 0.90-2.63; <60 mm Hg: HR, 2.12; 95% CI, 1.20-3.74;P=0.0055 for trend). The associations of DBP with death (≥90 mm Hg: HR, 1.86; 95% CI, 1.12-3.06; 80-89 mm Hg: HR, 1.23; 95% CI, 0.89-1.70; 70-79 mm Hg: referent; 60-69 m...Continue Reading

References

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Apr 11, 2014·The New England Journal of Medicine·Bertram PittUNKNOWN TOPCAT Investigators
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Nov 10, 2015·The New England Journal of Medicine·UNKNOWN SPRINT Research GroupWalter T Ambrosius
Sep 4, 2016·Journal of the American College of Cardiology·John W McEvoyElizabeth Selvin

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Citations

Jan 5, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Sang-Hyun IhmKwang Kon Koh
Sep 28, 2018·Current Cardiology Reports·Faisal Rahman, John W McEvoy
Dec 2, 2020·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Yuzhong WuChen Liu
Mar 13, 2021·Current Opinion in Cardiology·Peder L MyhreScott D Solomon

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Software Mentioned

TOPCAT
SPRINT
SAS

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