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

  • Elgendy IY & al.
  • ESC Heart Fail
  • 15 Dec 2019

  • International Clinical Digest
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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

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 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.