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238 Comparison of the clinical profiles of hypertensive patients with a history of heart failure and reduced versus preserved left ventricular ejection fraction – the O-PREDICT 2 study

Authors
Publisher
Elsevier France
Publication Date
Volume
2
Issue
1
Identifiers
DOI: 10.1016/s1878-6480(10)70240-8
Disciplines
  • Medicine

Abstract

While the links between high blood pressure and heart failure (HF) are well known, the clinical profiles of hypertensive patients (pts) according to measure of left ventricular (LV) ejection fraction (EF) remain poorly investigated. O-PREDICT 2 was a multicentre observational study conducted among 1537 general practitioners who classified 4427 hypertensive outpatients (pts) (mean age 72±9 years; 66% males) according to the presence (Group 1, 2969 Pts) or absence (Group 2, age > 65 years) of a history of clinical HF. The study cohort included 2052 (46.4%) pts with an available measure of LVEF, 1713 (58%) from group 1 and 350 from group 2. Results In group 1, 677 (39.5%) pts had a reduced EF ≤ 40% (1A) and 1036 (60.5%) had a preserved EF > 40% (1B), while, in group 2, 330 (94.3%) had a preserved EF. When comparing groups 1A, 1B and 2, a significant difference (p<.05) was found for history of hospitalization for HF (70.3%, 59.2% and 0%, respectively), SBP ≥ 140 mmHg (35%, 47.7% and 53.6%), coronary artery disease (52.2%, 40.4% and 15.2%), and myocardial infarction (69.2%, 52.3% and 46.8%). Incidence of atrial fibrillation (AF) was 11% in group 2 while in groups 1A and 1B it differed according to the NYHA functional class, reaching respectively 50.1% and 62.9% of the pts in class II, and 39.5% and 24.6% of the pts in class III. Reduced EF was more frequent in male (74% in group 1A vs. 64.2% in group 1B and 63.6% in group 2) than in female (26% vs. 35.8% and 36.4%, respectively). LV hypertrophy, cardiovascular disease, renal failure or arteriopathy, were evenly distributed in groups 1A and 1B. Conclusion Among hypertensive pts with a clinical history of HF, pts with preserved HF are more often female and presented with AF, while pts with systolic HF are more often hospitalized or presented with a history of coronary artery disease. However, even in case of preserved EF, the rates of hospitalizations and myocardial infarction remain markedly elevated (> 50%)

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