Author + information
- Charbel Abi Khalila,b,
- Kadhim Sulaimana,b,
- Rajvir Singha,b,
- Amin Jayyousia,b,
- Nidal Asaada,b,
- Khalid Al Habiba,b,
- Alawi Alsheikh-Alia,b and
- Jassim Al Suwaidia,b
Background: In patients with type 2 diabetes (T2D), a tight blood pressure control is not beneficial but a systolic blood pressure (SBP) > 140 mmHg is considered harmful. However, the optimal SBP in patients with T2D and heart failure (HF) is not known. We hypothesized that high blood pressure values in patients with T2D and HF are more beneficial than regular ones.
Methods: The Gulf-CARE (Gulf aCute heArt failuRe rEgistry) is a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure in 7 Middle Eastern countries. We studied 12-month mortality and hospitalizations for HF in patients with T2D hospitalized for acute decompensated heart failure, according to 5 SBP categories on discharge from the acute hospitalization: < 120, 120-129 (referent group), 130-149 and >150 mmHg.
Results: Among the 5005 patients admitted in the GULF-CARE registry, 2492 (49.8%) had T2D. A SBP <120 mmHg did not increase mortality risk or hospitalizations for heart failure (OR 1.11, 95% CI [0.75-1.65], p=0.61; OR 1.2, 95% CI [0.81-1.78], p=0.36; respectively), compared to the referent group. A SBP of 130-149 mmHg had a mortality risk similar to that of the referent group. Interestingly, a SBP >150 mmHg was associated with a lower mortality risk (OR 0.55, 95% CI [0.37-0.82], p=0.003). However, this was counteracted by an increase in hospitalizations for HF (OR 1.53, 95% CI [1.07-2.21], p=0.02). After adjustment for several risk variables, including age, gender, smoking, dyslipidemia, LVEF, heart rate, creatinine and medications at discharge, mortality risk was still significantly decreased in patients with a SBP of > 150 mmHg (OR 0.67, 95% CI [0.47-0.97], p=0.04), parallel to an increase in HF hospitalisations (OR 1.51, 95% CI [1.02-2.25], p=0.04).
Conclusions: In this cohort of patients with ADHF, high systolic blood pressure in patients with type 2 diabetes protected against mortality but increased the risk of hospitalizations for HF.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Heart Failure: Evaluating Strategies to Prevent Readmissions
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1163-296
- 2017 American College of Cardiology Foundation