| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 2
| Issue : 2 | Page : 80-85 |
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Visit-to-visit blood pressure variability in patients with chronic heart failure with reduced ejection fraction
Zhanna Kobalava1
 , Yulia Kotovskaya2
, Elena Troitskaya1
, Lala Babaeva1
, Usha T Parvathy3
, Peter A Brady4 1 Department of Internal Diseases with Courses of Cardiology and Functional Diagnostics, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
2 Russian Clinical and Research Center of Gerontology, Pirogov's Russian National Research Medical University), Moscow, Russia
3 MPS Hospital, Podbelskovo Street, Department of Cardiac Surgery, RUDN University, Moscow, Russia
4 Department of Cardiology, Illinois Masonic Medical Center, Chicago, IL USA, India
5 Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University; Gulf Health Research, Muscat, Oman
Correspondence Address:
Prof.Dr. Zhanna Kobalava
Head of the Department, Department of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics Named after Prof. V.S. Moiseev, Institute of Medicine, RUDN University Moscow
Russia
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ACCJ.ACCJ_17_20
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Background: There is a growing evidence of the prognostic significance of visit-to-visit blood pressure variation in different groups of patients but for heart failure with reduced ejection fractions remains a matter of controversy. Objective: The objective of the study was to evaluate the impact of visit-to-visit blood pressure variability (BPV) on the prognosis in patients with stable heart failure (HF) with reduced ejection fraction (EF). Methods: The retrospective analysis included 100 pts (80 men, age 64.4 ± 9.3 years, baseline BP 127.6 ± 15.1/77.9 ± 8.3 mmHg) with chronic heart failure II-IV NYHA functional class with mean EF 32.3 ± 4.3%. All patients received optimal medical therapy for HF. BP was measured with a validated oscillometric device. Visit-to-visit BPV was calculated as standard deviation, and the coefficient of variation of average BP for seven visits during 18 months. The endpoints were death, myocardial infarction, stroke, and hospitalization for HF. Results: Visit-to-visit systolic BPV (SBPV) ranged between 2.3 and 20.0 mmHg. A total of 47 endpoints in 37 patients were recorded. The patients with endpoints had higher visit-to-visit SBPV (11.2 ± 4.0 vs. 9.5 ± 3.5 mmHg, P < 0.05). Logistic regression analysis revealed that the risk of all negative outcomes was independently associated with lower EF (adjusted odds ratio (aOR) 0.84; 95% confidence interval (CI): 0.73-0.97; P = 0.02) and SBPV > 10.9 mmHg (aOR 3.0; 95% CI: 1.27–7.06; P = 0.01). Conclusions: Visit-to-visit SBPV >10.9 mmHg as well as lower EF were independently associated with negative outcomes in patients with stable HF with reduced EF.
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