Utilidad de la monitorización ambulatoria de la presión arterial en el pronóstico de los pacientes con insuficiencia cardiaca

Identificador:  TDX:2305

Handle: https://hdl.handle.net/20.500.11797/TDX2305

Autors:  Camafort Babkowski, Miguel

Resum:
Hypertension is a major cause of heart failure. Since ambulatory blood pressure monitoring has proven to be a very reliable prognostic marker of cardiovascular disease in hypertensive patients without cardiovascular disease, and its data in patients with heart failure are scarce, mostly coming from series with a limited number of patients, we propose to study the prognostic value of ABPM in patients with HF. Our hypothesis is that ABPM is a good predictor of outcome of heart failure and an independent risk factor for the prognosis of these patients. We performed a prospective study in clinically stable patients with previous hospitalization for heart failure. Patients underwent ABPM, and demographic, comorbidities, geriatric, analytical data and echocardiographic evaluation were collected. Follow up was also performed for a year to determine the emergence of new hospitalizations or death during follow up of at least one year. A total of 154 patients were included, with a mean age of 76.77 years, 55.2% women. A total of 76.32% had HF with preserved ejection fraction. The results show that a non-dipping pattern is associated with a worse prognosis. However, the logistic regression analysis showed that it is not a factor, but only a marker of poor prognosis. Non dipping pattern is present in 74.02%, with higher prevalence of dyslipidemia as the only distinguishing feature. Nocturnal HT is present in a 45.45%, with a lower frequency of DM and lower frequency of hypertension as a cause of the IC as a differentiating feature. Half of the patients with HF, in our study, presented well controlled PA, with higher levels of urea and FC as differential characteristics. In conclusion ABPM Non dipping pattern is a risk marker of worse prognosis in real life Heart failure patients but not a risk factor