000			03456nam a22004457a 4500
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
942			_cART _dArticle
999			_c974 _d974