Effect of different diastolic blood pressure levels on the prognosis of elderly patients with heart failure with preserved ejection fraction

Objective To analyze the cardiac function and the adverse outcomes in elderly HFpEF patients with different diastolic blood pressure，and explore the risk factors of death. Methods A total of 207 participants enrolled in this study from March 2015 December 2016 were divided into LDBP group (24 h mean diastolic blood pressure <60 mm Hg, 1 mm Hg=0.133 kPa, n=98) and HDBP group (24 h mean diastolic blood pressure ≥60 mm Hg, n=109). NYHA function classification Ⅲ or Ⅳ, all-cause death, the incidence of non-fatal myocardial infarction and cardiac shock were analyzed. The patients were followed up for 1.5 years with the end point of all-cause death. Risk factors of death were analyzed by Cox regression. Results The severity of cardiac function, mortality, non-fatal myocardial infarction and cardiogenic shock in the LDBP group were higher than those in the HDBP group (all P<0.05). A total of 105 deaths (death group) were observed in 1.5 years of follow-up, and 102 in the survival group. Univariate analysis showed that there were differences in DBP, BMI, COPD, NT-proBNP and IVST levels between the death group and the survival group (all P<0.05). Multivariate Cox regression analysis showed that diastolic blood pressure <60 mm Hg and high IVST level were independent risk factors for death (all P<0.05). Conclusion Low DBP and high IVST increase the risks of death in HFpEF patients.