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A history of arterial hypertension does not affect mortality in patients hospitalised with congestive heart failure
  1. F Gustafsson1,
  2. C Torp-Pedersen2,
  3. M Seibæk1,
  4. H Burchardt3,
  5. O Wendelboe Nielsen1,
  6. L Køber1,
  7. for the DIAMOND study group
  1. 1Department of Cardiology B, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
  2. 2Department of Cardiology Y, Bispebjerg University Hospital, Copenhagen, Denmark
  3. 3Department of Cardiology P, Gentofte University Hospital, Copenhagen, Denmark
  1. Correspondence to:
    Dr Finn Gustafsson
    Department of Cardiology B 2012, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; finng{at}dadlnet.dk

Abstract

Objectives: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF).

Design: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had non-systolic CHF, and 57% had ischaemic heart disease.

Setting: 38 primary, secondary and tertiary hospitals in Denmark.

Main outcome measures: Total mortality 5–8 years after inclusion in the registry.

Results: Female sex and preserved left ventricular systolic function was more common among patients with a history of hypertension. 72% of the patients died during follow up. A hypertension history did not affect mortality risk (hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.92 to 1.07). Correction for differences between the normotensive and hypertensive groups at baseline in a multivariate model did not alter this result (HR 1.08, 95% CI 1.00 to 1.17, p  =  0.06). The hazard ratio was similar in patients with and without a history of ischaemic heart disease. Hence, a specific effect of hypertension in the group of patients with CHF with ischaemic heart disease, as suggested in earlier studies, could not be confirmed.

Conclusion: A history of arterial hypertension did not affect mortality in patients hospitalised with CHF.

  • ACE, angiotensin-converting enzyme
  • CHF, congestive heart failure
  • DIAMOND, Danish Investigations of Arrhythmia and Mortality
  • HR, hazard ratio
  • LVEF, left ventricular ejection fraction
  • MERIT-HF, Metoprolol CR/XL Randomized Intervention Trial in Chronic Heart Failure
  • WMI, wall motion index

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Footnotes

  • Competing interests: None declared.

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