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Open Access The Relationship between Abnormal Circadian Blood Pressure Rhythm and Risk of Readmission in Patients with Heart Failure with Preserved Ejection Fraction

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

Objective: Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive target organ damage and cardiovascular events, but its association with readmission risk in patients with heart failure with preserved ejection fraction (HFpEF) remains unknown. We conducted a retrospective study to explore the relationship between circadian blood pressure rhythm and readmission risk in HFpEF patients.

Methods: We retrospectively collected baseline and follow-up data on HFpEF patients who underwent ambulatory blood pressure monitoring (ABPM) from May 2015 to October 2019. Patient circadian blood pressure rhythms defined by ABPM were grouped as dipper, nondipper, or riser patterns. Univariate and multivariate linear regression analyses were performed to assess the association between circadian blood pressure rhythm and readmission risk.

Results: A total of 122 patients were enrolled in this study. The mean age and ejection fraction were 69.87 years and 61.44%, respectively, with mean the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level being 1048.15 pg/mL. There were significant differences in the 24-hour systolic blood pressure (SBP), sleep SBP, and sleep diastolic blood pressure (DBP) among the three groups, where the 24-hour SBP, sleep SBP, and sleep DBP in the riser pattern group were markedly higher than in the dipper pattern group. Notably, serum NT-proBNP levels, the proportion of patients readmitted for heart failure and the mean number of admissions differed markedly among three groups. Instructively, multivariate linear regression analysis showed that the riser pattern was a significant and independent risk factor for increased serum NT-proBNP level (β = 929.16, 95% confidence interval 178.79‐1679.53, P = 0.016). In multivariate logistic regression analysis, the riser pattern was demonstrated to be a significant risk factor for readmission (odds ratio 11.23, 95% confidence interval 2.01‐62.67, P = 0.006) in HFpEF patients.

Conclusion: The riser blood pressure pattern is a potential risk factor for elevated serum NT-proBNP level and readmission in HFpEF patients.

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Keywords: Heart failure with preserved ejection fraction; N-terminal pro-B-type natriuretic peptide; ambulatory blood pressure monitoring; circadian blood pressure rhythm; readmission; riser pattern

Document Type: Research Article

Affiliations: 1: Department of Cardiology, the First People’s Hospital of Fuyang District in Hangzhou, Hangzhou, 311400, China 2: Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China

Publication date: May 1, 2021

This article was made available online on April 6, 2021 as a Fast Track article with title: "The Relationship between Abnormal Circadian Blood Pressure Rhythm and Risk of Readmission in Patients with Heart Failure with Preserved Ejection Fraction".

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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