| Study | Population | P‡ | Patient characteristics | No of patients (no of events) | Mean (SD) follow-up (years) | Mean (SD) SBP(mm Hg) | NYHA class | Mean (SD) EF | Mean age | Male(%) | Aetiology (%) | β‡ | A‡ | C‡ | D‡ | Hazard ratio for death |
| Lee 20065 | DIG database; RCT | No | Patients with stable HF and normal sinus rhythm | 5747 (2066) | 3.2 | Not recorded | II (64%) III (36%) | 28 (9) | 63 | 77 | Ischaemic (72) Hypertensive (8) Valvular (2) Idiopathic (19) Alcoholic (3) | U | 95 | U | 81 | 0.89 (0.86 to 0.91) per 10 mm Hg increase |
| Davos 200312 | 589 Consecutive patients presenting to HF clinic | Yes | Diagnosis of HF on clinical and echo/RV diagnosis | 589 (208) | 4.4 (2.1) | 122.9 (34.8) | I (101) II (230) III(152) IV(42) | 30.9 (0.73) | 65 | 88 | Not recorded | 7 | 48.5 | 16.2 | 84.6 | 0.99 (0.98 to 0.99) per 1 mm Hg increase |
| Robbins 199913 | Consecutive patients with HF referred for metabolic stress testing | Yes | Patients 18–70 with chronic HF under evaluation for heart transplantation. Exclusion criteria—β blocker or IV ionotropes | 470 (71) | 1.5 | 111 (18) | Not recorded | 20 (27) | 52 | 71 | 47 CAD | 0 | 86 | U | 79 | 1.4 (1.06 to 1.85) per 18 mm Hg decrease |
| Huynh 200614 | RCT | Yes | Patients >70 years old. recently discharged with HF with ⩾1 risk factors for early hospital readmission | 282 (269) | 14 | 158 (52) | 2.4 (1.0) | 42.5 (19.1) | 79 | 36 | Ischaemic (56) | 11 | 64 | 41 | 84 | 1.0 (0.99 to 1.0) per 1 mm Hg increase |
| Koike 200015 | Consecutive patients with cardiac disease referred for CPX | Yes | Consecutive patients with known cardiac disease. Exclusion criteria—UA, MI within 1 month, documented lung or cerebrovascular disease | 249 (29) | 9.1 (1.7) | 140 (24) | I (46) II (45) III (9) | Not recorded | 56 | 60 | IHD (34) Valvular (24) Hypertensive (23) Other (19) | U | U | U | U | 1.01 (0.99 to 1.023) per 1 mm Hg decrease |
| Rickli 200316 | Consecutive patients referred to HF clinic | Yes | HF with LVEF <40 and able to perform a CPX test | 202 (44) | 2.4 (1.7) | 103 (17) | I (7) II (101) III (90) IV (4) | 28 (7) | 52 | 86 | CAD (53) DCM (34) Valvular (2) Hypertension (2) Other or combined (9) | 45 | 99† | U | 90 | 0.8 (0.65 to 0.98) per 10 mm Hg increase |
| Cicoira 200117 | Consecutive patients referred to heart failure clinic | Yes | Age >70 with a history of dyspnoea and symptomatic exercise tolerance. Optimised medical regimen | 188 (61) | 1.5 (0.6) | 133 (22) | Mean 2.3 (0.8) | 38 (17) (n = 105) | 77 | 71 | Ischaemic (66) IDCM (14) Valvular (7) Restrictive (5) HCM (2) | 15 | 85 | U | 72 | 0.98 (0.96 to 0.99) per 1 mm Hg increase |
| Terrovitis 200618 | RCT | Yes | NYHA class II–IV, LVEF ⩽35% on radionuclide ventriculography | 160 (55) | 2 | 114 (18) | I (6) III (45) III (42) IV (7) | 20 (9) | 56 | 0.85 | Ischaemic (46) Non-ischaemic (54) | 28 | U | U | 91 | 0.98 (0.96 to 0.99) per 1 mm Hg increase |
| Pousset 200019 | RCT | Yes | Clinically stable CHF, LVEF <45% with at least 1 month on constant treatment. Exclusions—MI in past 3 months | 117 (14) | 0.64 (0.38) | 123 (23) | I (7) II (62) III (25) IV (6) | 28 (10) | 55 | 79 | IDCM (64) CAD (28) Anthracycline induced (3) Hypertension (3) Valvular (3) | 17 | 91 | U | 82 | 0.35 (0.18 to 0.69) per 23 mm Hg increase |
| Walsh 199720 | Patients enrolled in clinical trials of heart failure drugs | Yes | Symptomatic HF for at least 2 months with cardiomegaly on CXR. LVEF <35 or an increase in LVEDV >5.5 and fractional shortening <30% | 84 (43) | 1.9 | 120* (94–180) | II (56) III (44) | Not recorded | 64* | 88 | CAD (65) Non-ischaemic cardiomyopathy (35) | U | 23 | U | 100 | 0.97 (0.96 to 0.98) per 1 mm Hg increase |
*Median (range); †99% were receiving ACE inhibitors or angiotensin receptor blockers; ‡A, ACEi; β, β blockers; C, CCB; D, diuretics; P, prospective.
ACEi, angiotensin converting enzyme inhibitors; CAD, coronary artery disease; CPX, cardiopulmonary exercise test; CCB, calcium channel blockers; CHF, chronic heart failure; DCM, dilated cardiomyopathy; EF, ejection fraction; HCM, hypertrophic cardiomyopathy; HF, heart failure; IDCM, ischaemic dilated cardiomyopathy; IHD, ischaemic heart disease; IV, intravenous; LVEDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NYHA, New York Heart Association; RCT, randomised control trial; RV, radionucleotide ventriculography; SBP, systolic blood pressure; U, unknown value (data not recorded in original study); UA, unstable angina.