Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Departments of Public Health, Mekelle University, Ethiopia.
Eur J Heart Fail. 2016 Jan;18(1):38-45. doi: 10.1002/ejhf.427. Epub 2015 Oct 28.
Hypertension is a known risk factor for the development of heart failure (HF); however, few data are available on the magnitude of short- and long-term progression from hypertension to HF. The present study aims to determine the short- and long-term incidence of HF, and identify factors associated with onset of HF in elderly hypertensive patients.
The incidence of HF was measured in 6083 hypertensive patients, in the Second Australian National Blood Pressure Study (ANBP2), followed for a median of 10.8 years (4.1 years during the trial and 6.7 years during post-trial follow-up). A total of 373 cases of HF were identified over 59 581 person-years of follow-up (PY). The overall cumulative incidence of HF was 6.26 per 1000 PY; 5.33 per 1000 PY during the ANBP2 clinical trial and 7.04 per 1000 PY during the post-trial follow-up. HF was 63% higher among men [incidence rate ratios (IRR) 1.63, P < 0.01]. Older age, male sex, obesity, and history of cardiovascular disease independently predicted HF during both the short- and long-term follow-up. In addition, diabetes and smoking were associated with onset of HF in the short-term follow-up, and higher systolic blood pressure in the long-term follow-up. Median survival following diagnosis with HF was 3.94 years, and women (6.06 years) had a survival advantage over men (3.32 years).
Heart failure is a frequent long-term outcome in treated elderly hypertensive patients. Development of HF was predicted by patient characteristics and co-morbidities, with the effect of some predictors varying over the short- and long-term follow-up.
高血压是心力衰竭（HF）发展的已知危险因素；然而，关于高血压向 HF 短期和长期进展的程度的数据很少。本研究旨在确定老年高血压患者 HF 的短期和长期发生率，并确定与 HF 发病相关的因素。
在第二项澳大利亚国家血压研究（ANBP2）中，对 6083 例高血压患者进行了 HF 的发生率测量，中位随访时间为 10.8 年（试验期间为 4.1 年，试验后随访期间为 6.7 年）。在 59581 人年的随访期间共发现 373 例 HF 病例。HF 的总体累积发生率为 6.26/1000 人年；ANBP2 临床试验期间为 5.33/1000 人年，试验后随访期间为 7.04/1000 人年。男性 HF 的发生率高出 63%[发病率比（IRR）1.63，P<0.01]。年龄较大、男性、肥胖和心血管疾病史在短期和长期随访中均独立预测 HF。此外，糖尿病和吸烟与短期随访中的 HF 发病相关，而长期随访中较高的收缩压与 HF 发病相关。HF 确诊后的中位生存时间为 3.94 年，女性（6.06 年）的生存优势超过男性（3.32 年）。
HF 是治疗后老年高血压患者的常见长期结局。HF 的发展可由患者特征和合并症预测，一些预测因素的作用在短期和长期随访中有所不同。
