Gustafsson F, Torp-Pedersen C, Seibaek M, Burchardt H, Nielsen O Wendelboe, Køber L
Department of Cardiology B, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Heart. 2006 Oct;92(10):1430-3. doi: 10.1136/hrt.2005.080572. Epub 2006 Apr 18.
To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF).
Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had non-systolic CHF, and 57% had ischaemic heart disease.
38 primary, secondary and tertiary hospitals in Denmark.
Total mortality 5-8 years after inclusion in the registry.
Female sex and preserved left ventricular systolic function was more common among patients with a history of hypertension. 72% of the patients died during follow up. A hypertension history did not affect mortality risk (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.92 to 1.07). Correction for differences between the normotensive and hypertensive groups at baseline in a multivariate model did not alter this result (HR 1.08, 95% CI 1.00 to 1.17, p = 0.06). The hazard ratio was similar in patients with and without a history of ischaemic heart disease. Hence, a specific effect of hypertension in the group of patients with CHF with ischaemic heart disease, as suggested in earlier studies, could not be confirmed.
A history of arterial hypertension did not affect mortality in patients hospitalised with CHF.
评估高血压病史对大量因充血性心力衰竭(CHF)住院患者长期死亡率的影响。
对5491例连续患者进行回顾性分析,其中24%有高血压病史。60%的患者为非收缩性CHF,57%有缺血性心脏病。
丹麦的38家一级、二级和三级医院。
纳入登记后的5至8年总死亡率。
有高血压病史的患者中女性及左心室收缩功能保留更为常见。72%的患者在随访期间死亡。高血压病史不影响死亡风险(风险比(HR)0.99,95%置信区间(CI)0.92至1.07)。在多变量模型中对基线时血压正常组和高血压组之间的差异进行校正后,这一结果未改变(HR 1.08,95%CI 1.00至1.17,p = 0.06)。有缺血性心脏病病史和无缺血性心脏病病史的患者风险比相似。因此,早期研究中提示的高血压在伴有缺血性心脏病的CHF患者组中的特定作用未得到证实。
动脉高血压病史不影响因CHF住院患者的死亡率。