Long-term survival following the development of heart failure in an elderly hypertensive population.

Background: Available data on the prognosis of heart failure (HF) patients is predominantly limited to patients diagnosed at time of hospitalization. AIMS: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second...

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Main Authors: Sahle, B., Owen, A., Wing, L., Beilin, L., Krum, H., Reid, Christopher, Second Australian National Blood Pressure Study Management Committee
Format: Journal Article
Published: Wiley-Blackwell Publishing Ltd. 2017
Online Access:http://hdl.handle.net/20.500.11937/56806
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author Sahle, B.
Owen, A.
Wing, L.
Beilin, L.
Krum, H.
Reid, Christopher
Second Australian National Blood Pressure Study Management Committee
author_facet Sahle, B.
Owen, A.
Wing, L.
Beilin, L.
Krum, H.
Reid, Christopher
Second Australian National Blood Pressure Study Management Committee
author_sort Sahle, B.
building Curtin Institutional Repository
collection Online Access
description Background: Available data on the prognosis of heart failure (HF) patients is predominantly limited to patients diagnosed at time of hospitalization. AIMS: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second Australian National Blood Pressure Study (ANBP2) randomized 6083 hypertensive subjects aged 65-84 years to angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic-based therapy and followed them for a median of 4.1 years. One hundred forty-five participants who developed HF and 5938 who remained free from HF during the trial period were followed for a median of 6.7 years during a post-trial follow-up. Results: Three quarters, 110 (76%) of HF patients had died at the end of the follow-up. The five and ten-year survival rates following HF diagnosis during the trial period were 37% and 15%, respectively in men, compared with 60% and 33%, respectively in women. In non-heart failure participants the five and ten-year survival rates, following enrolment into the study, were 92% and 76%, respectively. Mortality following HF diagnosis increased with advancing age (HR=1.09, 95% CI: 1.04-1.33). In addition, male gender and pre-existing diabetes were predictive of mortality, while ACE inhibitor-based therapy for the initial trial was associated with 39% decrease (HR=0.61, 95% CI: 0.41-0.91) in mortality compared with a thiazide-diuretic-based regimen. Conclusions: Long-term survival in an elderly HF patients is poor, especially in men. Mortality in HF patients increased progressively with advancing age, while allocation to the ACE inhibitor-based regimen for the initial trial significantly improved HF outcome.
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spelling curtin-20.500.11937-568062018-01-05T04:19:45Z Long-term survival following the development of heart failure in an elderly hypertensive population. Sahle, B. Owen, A. Wing, L. Beilin, L. Krum, H. Reid, Christopher Second Australian National Blood Pressure Study Management Committee Background: Available data on the prognosis of heart failure (HF) patients is predominantly limited to patients diagnosed at time of hospitalization. AIMS: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second Australian National Blood Pressure Study (ANBP2) randomized 6083 hypertensive subjects aged 65-84 years to angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic-based therapy and followed them for a median of 4.1 years. One hundred forty-five participants who developed HF and 5938 who remained free from HF during the trial period were followed for a median of 6.7 years during a post-trial follow-up. Results: Three quarters, 110 (76%) of HF patients had died at the end of the follow-up. The five and ten-year survival rates following HF diagnosis during the trial period were 37% and 15%, respectively in men, compared with 60% and 33%, respectively in women. In non-heart failure participants the five and ten-year survival rates, following enrolment into the study, were 92% and 76%, respectively. Mortality following HF diagnosis increased with advancing age (HR=1.09, 95% CI: 1.04-1.33). In addition, male gender and pre-existing diabetes were predictive of mortality, while ACE inhibitor-based therapy for the initial trial was associated with 39% decrease (HR=0.61, 95% CI: 0.41-0.91) in mortality compared with a thiazide-diuretic-based regimen. Conclusions: Long-term survival in an elderly HF patients is poor, especially in men. Mortality in HF patients increased progressively with advancing age, while allocation to the ACE inhibitor-based regimen for the initial trial significantly improved HF outcome. 2017 Journal Article http://hdl.handle.net/20.500.11937/56806 10.1111/1755-5922.12303 Wiley-Blackwell Publishing Ltd. restricted
spellingShingle Sahle, B.
Owen, A.
Wing, L.
Beilin, L.
Krum, H.
Reid, Christopher
Second Australian National Blood Pressure Study Management Committee
Long-term survival following the development of heart failure in an elderly hypertensive population.
title Long-term survival following the development of heart failure in an elderly hypertensive population.
title_full Long-term survival following the development of heart failure in an elderly hypertensive population.
title_fullStr Long-term survival following the development of heart failure in an elderly hypertensive population.
title_full_unstemmed Long-term survival following the development of heart failure in an elderly hypertensive population.
title_short Long-term survival following the development of heart failure in an elderly hypertensive population.
title_sort long-term survival following the development of heart failure in an elderly hypertensive population.
url http://hdl.handle.net/20.500.11937/56806