THE ROLE OF HYPERTENSION ON SHORT-TERM OUTCOME OF PATIENTS HOSPITALISED FOR ACUTE HEART FAILURE - CARDIOGENIC SHOCK

Objective: The effect of previous long-term hypertension (HT) on mortality in patients with cardiogenic shock (CS) is not well known.  The aim of the study was to characterise patients with history of HT who develop CS and to assess its influence on short-term mortality.
Methods: We used data from the Czech acute heart failure registry. Between September 2006 and October 2009, 600 patients with CS were hospitalised at 7 study centres. Demographic, clinical and laboratory profile, treatment and in-hospital mortality rates were assessed according to presence of previous HT. Predictors of short-term outcome were identified using univariate analysis.
Results: Patients with previous HT (N=391, 65%) were significantly older (74.1 vs. 66.8 years in non-HT group, P<0.001), more of female gender (43% vs. 33%, P<0.05), having more often history of diabetes (51% vs. 25% non-HT, P<0.001), myocardial infarction (39% vs. 29% P<0.05) and stroke (19% vs. 7%, P=0.001). HT group presented with higher BMI (27.6 vs. 26.7 kg/m2, P<0.05), worse renal function (entry serum creatinine,132 vs. 127.0 µmol/l, P<0.05) and lower haemoglobin level (127 vs. 132.7 g/l, P<0.05). Despite similar LV EF (HT 33.7%, non-HT 32%, P=NS) and length of hospital stay (7 vs. 6.9 days, P=NS), HT patients had worse in-hospital mortality rates (66% vs. 54%, P<0.05). In univariate analysis HT increased shot-time mortality risk with OR 1.57 (95% CI: 1.06; 2.33, P<0.05). Other significant predictors of short-term outcome are shown in Table 1.
Conclusion: HT is common co-morbidity in patients with CS and contributes to vascular and organ impairment and increases shot-term outcome.