Prognostic factors in patients with essential hypertension complicated by heart failure with reduced ejection fraction in vulnerable phase
ZHANG Lu
LU Honghong
ZHOU Birong
Abstract：Objective To investigate the prognostic factors in patients with essential hypertension(EH)complicated by heart failure with reduced ejection fraction(HFrEF)in vulnerable phase.Methods General and prognostic data were collected from 263 patients with EH complicated by HFrEF who received outpatient or inpatient treatment at the First Affiliated Hospital of Anhui Medical University from Dec.2022 to Oct.2024.All patients were followed up via telephone at 3 months after discharge.The follow-up endpoints were defined as disease progression within 3 months,including readmission due to heart failure(HF)and cardiac death.Enrolled patients were divided into 3 groups(poor prognosis group,moderate prognosis group,and favorable prognosis group)based on the occurrence of endpoint events and the follow-up left ventricular ejection fraction(LVEF)values.The influencing factors of prognosis were analyzed by using Logistic regression analysis in this population during vulnerable phase.A value of P<0.050 was considered statistically significant.Results(1)A total of 68 patients were classified into poor prognosis group,including 5 cases of cardiac death and 63 cases readmitted due to HF;174 patients were assigned to moderate prognosis group;and 21 patients were categorized into favorable prognosis group.(2)Compared with favorable prognosis group,moderate prognosis group had a higher proportion of patients with atrial fibrillation(AF)and diabetes history,along with abnormally elevated levels of C-reactive protein(CRP)and admission B-type natriuretic peptide(BNP),as well as a significantly decreased estimated glomerular filtration rate(eGFR,P<0.050).Compared with favorable prognosis group,poor prognosis group presented with a higher proportion of male patients,smokers,and those with AF history,diabetes history and chronic kidney disease(CKD)history,accompanied by significantly reduced levels of serum albumin(ALB),left ventricular ejection fraction(LVEF)and eGFR,as well as abnormally increased CRP and admission BNP levels(P<0.050).When compared with moderate prognosis group,poor prognosis group had a higher proportion of male patients,smokers and those with CKD history,along with a significantly decreased eGFR and abnormally elevated admission BNP levels(P<0.050).(3)Results of ordinal multivariate Logistic regression analysis showed that male sex(OR=1.322,95%CI:1.035～1.689),ALB<35 g/L(OR=1.340,95%CI:1.031～1.744),eGFR<60 mL/(min·1.73 m2,OR=1.644,95%CI:1.173～2.303),admission BNP level>1500 pg/mL(OR=1.765,95%CI:1.190～2.617)and baseline LVEF(OR=0.868,95%CI:0.778～0.969)were independent influencing factors for the prognosis in patients with hypertension complicated by HFrEF during vulnerable phase.Conclusion Patients with EH complicated by HFrEF are at a high risk of HF readmission and cardiovascular death during vulnerable phase,while some patients still achieve favorable prognosis.Among these factors,male sex,ALB level,eGFR value,admission BNP level and baseline LVEF are independent influencing factors for the prognosis in such patients during vulnerable phase.
Keywords：essential hypertensionheart failure with reduced ejection fractionvulnerable phaseprognosisrisk factors
Publication Date：2026-01-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：6( 53-58 )