000 | 03456nam a22004457a 4500 | ||
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008 | 220124s20212021 xxu||||| |||| 00| 0 eng d | ||
022 | _a0002-9343 | ||
024 | _a10.1016/j.amjmed.2021.11.012 [doi] | ||
024 | _aS0002-9343(21)00795-6 [pii] | ||
040 | _aOvid MEDLINE(R) | ||
099 | _a34861194 | ||
245 | _aInitiation of Anti-Hypertensive Drugs and Outcomes in Patients with Heart Failure with Reduced Ejection Fraction. | ||
251 | _aAmerican Journal of Medicine. 2021 Nov 30 | ||
252 | _aAm J Med. 2021 Nov 30 | ||
253 | _aThe American journal of medicine | ||
260 | _c2021 | ||
260 | _fFY2022 | ||
260 | _p2021 Nov 30 | ||
265 | _saheadofprint | ||
266 | _d2022-01-25 | ||
501 | _aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - present | ||
520 | _aBACKGROUND: In patients with heart failure with reduced ejection fraction (HFrEF) and hypertension, systolic blood pressure is recommended to be maintained below 130 mmHg, although this has not been shown to be associated with improved outcomes. We examined the association of anti-hypertensive drug initiation and outcomes in patients with HFrEF. | ||
520 | _aCONCLUSIONS: Among hospitalized older patients with HFrEF receiving contemporary treatments for heart failure, initiation of an anti-hypertensive drug was not associated with a lower risk of all-cause mortality or hospital readmission. Copyright (c) 2021. Published by Elsevier Inc. | ||
520 | _aMETHODS: In the Medicare-linked OPTIMIZE-HF, 7966 patients with HFrEF (ejection fraction <=40%) without renal failure were not receiving anti-hypertensive drugs before hospitalization, of whom 692 received discharge prescriptions for those drugs (thiazides and calcium channel blockers). We assembled a propensity score-matched cohort of 687 pairs of patients initiated and not initiated on anti-hypertensive drugs, balanced on 38 baseline characteristics. Hazard ratios (HR) and 95% confidence intervals (CI) for outcomes associated with anti-hypertensive drug initiation were estimated in matched cohort. | ||
520 | _aRESULTS: Matched patients (n=1374) had a mean age of 74 years, 41% were women, 17% were African American, 66% were discharged on renin-angiotensin system inhibitors and beta blockers, and 10% on aldosterone antagonists. During 6 (median 2.5) years of follow-up, 70% of the patients died and 53% had heart failure readmission. Anti-hypertensive drug initiation was not significantly associated with all-cause mortality (HR, 0.95; 95% CI, 0.83-1.07) or heart failure readmission (HR, 0.93; 95% CI, 0.80-1.07). Similar associations were observed during 30 days and 12 months of follow-up. | ||
546 | _aEnglish | ||
650 | _aIN PROCESS -- NOT YET INDEXED | ||
651 | _aMedStar Heart & Vascular Institute | ||
651 | _aMedStar Washington Hospital Center | ||
656 | _aInternal Medicine Residency | ||
656 | _aMedStar Georgetown University Hospital | ||
657 | _aJournal Article | ||
700 | _aAllam, Shalini | ||
700 | _aLam, Phillip H | ||
700 | _aSheikh, Farooq | ||
700 | _aTsimploulis, Apostolos | ||
790 | _aAhmed A, Allam SD, Allman RM, Aronow WS, Arundel C, Bhyan P, Deedwania P, Faselis C, Fonarow GC, Kanonidis IE, Lam PH, Patel S, Raman VK, Sheikh FH, Tsimploulis A | ||
856 |
_uhttps://dx.doi.org/10.1016/j.amjmed.2021.11.012 _zhttps://dx.doi.org/10.1016/j.amjmed.2021.11.012 |
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942 |
_cART _dArticle |
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999 |
_c974 _d974 |