What is the optimal BP and heart rate in HF with CAD?

Takeaway

• In patients who have heart failure (HF) and coronary artery disease (CAD), the optimal systolic BP appears to be 120-140 mmHg and the optimal heart rate <85 bpm.

Why this matters

• The optimal window for systolic BP and heart rate in this patient group has been elusive.

Key results

• Mean follow-up was 2.5 years. Having HF vs not having HF with CAD was tied to increased risk for the primary outcome (composite of all-cause death, first myocardial infarction, stroke): HR, 2.55 (95% CI, 2.30-2.83).
• Similar risks were found for each primary outcome component separately.
• With history of HF, a systolic BP <120 mmHg or >140 mmHg was tied to worse outcomes.
• Drug choice for treating hypertension was not associated with the primary outcome.
• A heart rate ≥85 bpm was also tied to worse outcomes.

Study design

• Data were analyzed for 1256 patients with HF, a subcohort from the multicenter INternational VErapamil SR-Trandolapril Study (n=22,576 CAD patients).
• Funding: BASF Pharma; Abbott Laboratories; University of Florida Research Foundation and Opportunity Fund.

Limitations

• Patients with most severe HF were excluded.
• No data on left ventricular ejection fraction.