|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Death Risk Jumps for Heart Failure Patients with Low
Systolic Blood Pressure
Heart failure most common hospital discharge
diagnosis for seniors
 November 7, 2006 Patients admitted to hospitals
with heart failure and low systolic blood pressure are more likely to
have problems, including a significantly higher risk of death, despite
medical treatment, says a study to be published tomorrow in the Journal
of the American Medical Association.
| |
Related Stories |
|
| |
Hardening of the Arteries Caused by a Communications
Failure
Old arteries not getting message to relax as
they did when young
 November 6, 2006 A diagnosis feared by senior
citizens "hardening of the arteries" may be caused by a lack of
communications, says new research. The old blood vessels still have the
ability to relax, much as they did when they were younger, but they are
not getting the message. It is this age-related loss of elasticity that
often is a prelude to high blood pressure and cardiovascular disease.
Read more...
Senior
Citizens Often Have Peripheral Arterial Disease Without Knowing It
September
14, 2006 - More than 8 million men and women - one in 20 adults and most
senior citizens - have peripheral arterial disease (PAD), a largely
unrecognized condition which puts them at risk for heart attack and stroke.
The symptoms of PAD, such as fatigue, heaviness, pain and cramping in the
leg muscles when walking that go away with rest, are often mistaken for
signs of aging and ignored. More often, the disease is silent, causing no
noticeable symptoms. A coalition is launching a campaign to make Americans
more aware of this risk and a simple test for detecting the condition.
Read more...
High Blood Pressure is Latest Major Topic on NIH's
Senior Citizen Health Site
'The Silent Killer' is the 29th health topic
added to NIHSeniorHealth
September
20, 2006- Information prepared specifically for senior citizens about
high blood pressure has been added to the National Institutes of
Health's special Website NIHSeniorHealth.com. High blood pressure is a
major health risk for older Americans. If it isnt treated, it can lead
to stroke, heart disease, kidney failure, and other serious health
problems. Read
more...
Read more
on
Health & Medicine |
|
Acute heart failure is a major public health
concern because of its prevalence and associated illness and death. In
2003, 1.1 million patients were discharged from the hospital for heart
failure, making this the most common discharge diagnosis among patients
older than 65 years, according to background information in the article.
Recent studies have indicated that the majority of
patients hospitalized for heart failure are admitted with low or normal
systolic blood pressure (SBP is the peak pressure in the arteries during
the cardiac cycle).
Elevated SBP may identify patients with certain
clinical characteristics that are unique from those in patients with low
SBP.
Mihai Gheorghiade, M.D., of the Feinberg School of
Medicine, Northwestern University, Chicago, and colleagues evaluated the
relationship between SBP at admission, patient clinical data, and
outcomes in patients hospitalized for acute heart failure.
The researchers analyzed data from the Organized
Program to Initiate Lifesaving Treatment in Hospitalized Patients with
Heart Failure (OPTIMIZE-HF) registry and performance-improvement
program, which included patients hospitalized with heart failure at 259
U.S. hospitals between March 2003 and December 2004. Patients were
divided into quartiles by SBP at hospital admission (<120, 120-139,
140-161, and >161 mm Hg).
In-hospital outcomes were based on 48,612 patients
age 18 years or older with heart failure. Of the 41,267 patients who had
left ventricular function assessed, 21,149 (51 percent) had preserved
left ventricular function. Outcomes following discharge from the
hospital were based on a prespecified subgroup (n = 5,791, approximately
10 percent of patients) with follow-up data for between 60 and 90 days.
The researchers found that lower SBP at admission
was associated with substantially increased in-hospital risk of death:
7.2 percent (for blood pressure <120 mm Hg), 3.6 percent (120-139 mm
Hg), 2.5 percent (140-161 mm Hg), and 1.7 percent (>161 mm Hg).
The odds of in-hospital death increased 21 percent
for each 10-mm Hg decrease in SBP below 160 mm Hg. In the follow-up
group, higher SBP at admission was also associated with lower risk of
60- to 90-day death.
Patients with higher SBP were more likely to be
female and black. Fifty percent of the patients had SBP higher than 140
mm Hg at admission.
this analysis demonstrates that SBP at hospital
admission, a readily accessible vital sign, is an important and
independent predictor of morbidity and mortality in patients with heart
failure, including patients with reduced or relatively preserved
systolic function. Systolic blood pressure at hospital admission can
effectively identify groups of patients that differ with respect to
clinical characteristics, prognosis, and perhaps underlying
pathophysiology. Accordingly, the therapeutic approach may vary among
patients with high, normal, or low SBP, the authors write.
Editorial:
Systolic and Nonsystolic Heart Failure - Equally Serious Threats
In an accompanying editorial, Per Hildebrandt,
M.D., D.M.Sc., of Roskilde University Hospital, Roskilde, Denmark,
comments on the two studies on heart failure in this weeks issue of
JAMA.
The findings
that approximately half of patients
with heart failure, whether observed in the community or in the
hospital, have preserved systolic function and that mortality in these
patients is similar to that for patients with heart failure and reduced
systolic function have important implications. Just as heart failure
with reduced LVEF [left ventricular ejection fraction] has long been
recognized as a common and serious disease and has been the subject of a
number large-scale clinical trials, the entities of heart failure with
preserved LVEF and diastolic dysfunction equally deserve attention.
Deciphering the mechanisms and developing evidence-based treatments for
these major public threats deserve the highest priority.
Editor's Note: Financial disclosures: Dr.
Hildebrandt reported receiving honoraria from AstraZeneca, Bristol-Myers
Squibb, GlaxoSmithKline, Merck, Novartis, Pfizer, Sanofi-Aventis,
Servier, and Takeda.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
