Clinical Characteristics Of Elderly Inpatients With Heart Failure With Preserved Ejection Fraction With Different Pulse Pressure

Objectives To analyze the clinical characteristics of elderly inpatients with heart failure with preserved ejection fraction(HFp EF)with different pulse pressure.Methods The clinical data of patients with HFp EF aged ≥65 years who were first admitted to the Fujian Medical University Union Hospital from January 2016 to October 2019 were collected.According to pulse pressure(PP)level(mm Hg),the patients were divided into the following 5 groups(PP<45,45≤PP<55,55≤PP<65,65≤PP<75,75≤PP).The clinical characteristics of changes of pulse pressure in the elderly inpatients with HFp EF were compared.Results(1)A total of 602 patients were included,with an average age of 77.0±6.5 years and 36.8% males.The average systolic pressure(SBP),diastolic blood pressure(DBP) and pulse pressure were 137.78±21.43,78.28±12.03,59.50±17.38 mm Hg respectively.(2)The patients of age,SBP,NYHA III-IV,total cholesterol(TC),N-terminal pro-Brain Natriuretic Peptide(NT-pro BNP),aorta diameter(AO),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),E/e’ were increased while heart rate(HR)at admission,hemoglobin(Hb),estimated glomerular filtration rate(e GFR) were decreased in the higher PP groups when compared to the lower PP groups(P all <0.05).(3)Using partial correlation analysis,after being controlled for the influence of other indicators,PP was positively correlated with SBP and NYHA III-IV(r=0.835,r=0.116,P<0.05),while negatively correlated with HR,Hb,and e GFR(r=-0.246,r=-0.249,r=-0.146,P<0.05).Using Pearson simple correlation analysis,PP was positively correlated with age(r = 0.120,P <0.05).(4)There were more comorbidities such as hypertension,chronic kidney disease and type 2 diabetes in the higher pulse pressure groups than those in the lower PP groups(P<0.05).However there was no statistical difference among different pulse pressure groups in comorbidities including coronary heart disease,atrial fibrillation and ischemic stroke(P>0.05).(5)The use of ACEI/ARB,CCB,loop diuretics,and spironolactone were more in the higher PP groups than those in the lower PP groups(P<0.05),while the use of β-blockers there was no statistical difference among different groups(P>0.05).Conclusions The elderly inpatients with HFp EF with higher pulse pressure had the characteristics of older age,higher systolic blood pressure,higher proportion of NYHA III-IV,slower heart rate at admission,lower hemoglobin level,lower e GFR,and received more drugs such as ACEI/ARB,CCB,loop diuretics,and spironolactone.Pulse pressure,as a simple and easy-to-obtain clinical indicator,may reflect the changes of clinical indicators of elderly inpatients with HFp EF,which is of great significance for early identification and early prevention of elderly HFpEF.