Target blood pressure values in heart failure

Czech version

Authors: J. Špinar ¹; J. Pařenica ¹; L. Špinarová ²; J. Vítovec ²; F. Málek ³
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno ¹; I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně ²; Kardiocentrum, Nemocnice Na Homolce, Praha ³
Published in: Kardiol Rev Int Med 2017, 19(2): 84-88

Overview

Hypertension is an important risk factor for heart failure and it is one of the basic criteria of the SCORE system together with age, sex and cholesterol levels. However, the relation is probably not strictly causal, with ischaemic heart disease as an intermediate factor. An effective treatment of hypertension in younger and middle age has a clear preventive effect on the development of ischaemic heart disease and heart failure. A history of hypertension is present in more than 50% of patients with heart failure, however, the age of the patients also plays an important role, because the mean age of patients with heart failure is about 70 years and at this age hypertension is present in more than 50% of patients with or without heart failure. The target blood pressure values are generally < 140/90 mm Hg, however, we have to be aware of the so-called J curve phenomenon frequently mentioned in patients with ischaemic heart disease and/or heart failure, meaning that lower blood pressure values can actually worsen the prognosis of heart failure. This was confirmed by many large clinical trials, for example with ACE inhibitors. Target blood pressure values are not mentioned in the Guidelines for Hypertension or Guidelines for Heart failure either. In the Czech FAR NHL registry with 1,100 patients with chronic heart failure, the lowest rate of mortality and/or hospitalisation was observed in patients with the first grade of hypertension, i.e. blood pressure of 140–159/90–99 mm Hg.

Keywords:
hypertension – blood pressure – ischaemic heart disease – heart failure – mortality

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