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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Competing interests: None declared.