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TOPLINE
Patients with heart failure (HF) whose systolic blood pressure (SBP) remained in the target range for more time had reduced odds of kidney function decline at 1 year and a reduced long-term risk for death.
METHODOLOGY
- Researchers analyzed data from a prospective cohort study to evaluate whether keeping SBP in a target range over time was linked to reduced risks for renal function decline and long-term death in patients with HF.
- They included adults hospitalized for HF across 52 hospitals in China between August 2016 and May 2018.
- SBP was measured at 1, 6, and 12 months after discharge. Researchers calculated time in target range (TTR) as the percentage of time SBP stayed between 110 and 130 mm Hg from months 1 to 12, estimating values between visits.
- The outcomes were 1-year renal function decline, defined as a ≥ 20% reduction in estimated glomerular filtration rate (eGFR) from 1 to 12 months plus eGFR < 60 mL/min per 1.73 m² at 12 months, and 5-year all-cause mortality.
- The analysis for renal function decline included 1529 patients (mean age, 63.4 years; 35.5% women), with a median follow-up duration of 1 year. The death analysis included 2195 patients, with a median follow-up duration of 4.2 years.
TAKEAWAY
- Incidence of both renal function decline and death decreased significantly from the lowest to highest tertile of TTR (Ptrend < .001 and .009, respectively).
- After multivariable adjustment, each 1-SD increase in TTR of SBP (36%) was associated with 26% reduced odds of renal function decline (P = .008).
- Each 1-SD increase in TTR of SBP (35%) was associated with a 10% reduced risk for all-cause death (P = .01).
- Results remained consistent across relevant subgroups, when using 6-month TTR measure, and when cardiovascular death was analyzed separately.
IN PRACTICE
"[The] findings underscore the importance of long-term BP management for renal protection and improving outcomes in patients with HF and supports TTR as a potential prognostic tool in HF care," the researchers wrote.
SOURCE
The study was led by Bin Wang, MD, PhD, of National Center for Cardiovascular Diseases in Beijing, China. It was published online on September 9 in the Journal of the American Heart Association.
LIMITATIONS
Patients with fewer than two BP measurements or missing creatinine data were excluded, limiting generalizability. Researchers did not determine the optimal time window, TTR cutoffs, or SBP target range. The study was observational and could not establish a cause-effect relationship between TTR and the outcomes.
DISCLOSURES
The study received funding from the Early Screening and Comprehensive Intervention for Populations at High Cardiovascular Risk -Beta-Blocker Optimization Management Education Course, the China Academy of Chinese Medical Sciences Innovation Fund for Medical Science, and National Key Research and Development Program from the Ministry of Science and Technology of China. The authors did not report any conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
