Three‑year survival of patients with chronic systolic heart failure due to hypertension: analysis of prognostic factors

INTRODUCTION Despite advances in medicine, chronic systolic heart failure (CHF) due to hypertension still constitutes a serious clinical challenge.
OBJECTIVES The aim of the study was to determine risk mortality factors in a 3‑year follow‑up of patients with CHF due to hypertension.
PATIENTS AND METHODS The study involved 140 consecutive stable inpatients with CHF (left ventricular end diastolic diameter >57 mm; left ventricular ejection fraction [LVEF] <40%), without epicardial artery stenosis (>30% vessel lumen), significant heart defect, diabetes, neoplastic, disease, or chronic kidney disease, with a minimum 5‑year history of hypertension, and administration of angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonists), β-adrenolytics, spironolactone and furosemide for 3 or more months. The follow‑up began on admission to the hospital after laboratory tests, resting electrocardiogram and echocardiogram, six‑minute walk test, coronarography, and endomyocardial biopsy. Late follow‑up data was obtained from the follow‑up visits or by telephone.
RESULTS The analysis involved 130 of 140 patients aged 47.8 ±7.9 years. The 3‑year mortality rate was 18.5%. Independent risk factors for death were LVEF (hazard ratio [HR], 0.881; 95% confidence interval [CI], 0.797–0.975, P <0.05), serum glucose (HR, 1.266; 95% CI, 1.085–1.627; P <0.05), N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP; HR, 1.369; 95% CI, 1.166–1.671; P <0.001), and bilirubin levels (HR, 1.057; 95% CI, 1.021–1.094; P <0.01).
CONCLUSIONS Beside LVEF and serum NT‑proBNP, other independent risk factors for death in patients with CHF due to hypertension are glucose and bilirubin levels.