Abstract 4139510: Nighttime home blood pressure was a crucial indicator in predicting adverse outcomes for patients with stage B heart failure

Background: Stage B heart failure (HF) was associated with increased cardiovascular and HF events. Hypertension is a risk factor for these events in Stage B HF. Nighttime blood pressure (BP) is more strongly associated with cardiovascular events than daytime BP, but nighttime home BP measurement is not widely used. Method: We analyzed 573 stage B HF patients with at least one cardiovascular risk factor who underwent home BP monitoring. Stage B HF was defined as BNP ≥35pg/ml, or NT-proBNP ≥125pg/ml, Troponin T >0.014ng/ml, LVEF <50%, enlarged left ventricular dimensions in diastole (≥60mm in men and ≥54mm in women), enlarged left atrium (>40mm), or increased left ventricular mass (>115g/m 2 in men and >95g/m 2 in women). Morning, evening, and nighttime home BP were measured by home BP devices, and cardiovascular events were followed up. Results: During a mean follow-up of 7.6 ± 3.6 years, 65 cardiovascular events occurred. Morning, evening, and nighttime home SBP were higher in the event group than in the non-event group (146±19 vs 140±14 mmHg, p=0.01, 137±17 vs 131±14 mmHg, p<0.01, 129±16 vs 123±14 mmHg, p<0.01, respectively). Kaplan Meier analysis showed that the high BP cut-off group defined by HT guidelines had significantly higher incidents of events in office, morning, and nighttime home SBP (p=0.03, p=0.02, p<0.01, respectively)(Figure). In multivariate Cox regression analysis adjusting for significant variables, nighttime home SBP >120mmHg was a significant predictor of the outcome (Hazard Ratio 2.03, 95% Confidence Interval: 1.13-3.65, p=0.02). Conclusions: Elevated nighttime home BP was a significant predictor for cardiovascular outcomes in stage B HF patients.