Association of age and baseline systolic blood pressure with outcomes in patients hospitalized for acute heart failure syndromes

Background: Baseline systolic blood pressure (SBP) is one of the most important prognostic indicators for patients with acute heart failure syndromes (AHFS). However, the association among age, baseline SBP, and outcomes of AHFS is unclear. This study was performed to evaluate the relation between baseline SBP and outcomes to increasing age in patients hospitalized for AHFS. Methods: Of the 4842 patients entered into the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4828 patients with in-hospital and postdischarge follow-up data were included. The patients were divided into quartiles of age (<65, 65 to 75, 76 to 82, and >= 83 years), and each age group was divided into quartiles of baseline SBP. Then the 1-year all-cause mortality was compared among the baseline SBP quartiles in the each age quartile. Results: After adjustment for multiple comorbidities, patients aged <65 years, 65 to 75 years, and 76 to 82 years showed no significant increase in the relative risk of all-cause mortality as the baseline SBP declined until the lowest SBP quartile (SBP < 112 mm Hg, < 120 mm Hg, and < 120 mm Hg, respectively). In contrast, among patients aged >= 83 years, the lower three SBP quartiles (SBP < 122 mm Hg, 122 to < 142 mm Hg, and 142 to < 165 mm Hg) were associated with a significantly higher risk of all-cause mortality than the highest SBP quartile. Conclusions: In patients hospitalized for AHFS, the relation between baseline SBP and all-cause mortality is markedly associated with increasing age, which means that baseline SBP is more important for very elderly patients with AHFS. (C) 2015 Elsevier Ireland Ltd. All rights reserved.