The Research About The Change Of Blood Pressure Levels Between Admission And Discharge Among Patients With Heart Failure

Purpose: Heart failure is a complex clinical symptoms group and theserious stage of various heart diseases. Because of the tight relationshipbetween blood pressure and cardiovascular events, out of control of bloodpressure will increase the risk of cardiovascular. But the study of the actuallevel of blood pressure and the variation of the blood pressure in the heartfailure patients is too little. The aim of this study is to investigate the level ofblood pressure on admission and its change between admission and dischargein patients with heart failure, especially the occurrence of hypotension，andprovide the basis for future clinical treatment.Methods:242patients admitted to the Second Hospital of Hebei MedicalUniversity from November2011to October2012with heart failure wereretrospectively evaluated.The level of blood pressure between admission and discharge in allpatients enrolled and the rate of patients with hypertension(BP≥140/90mmHg)、lower blood pressure (BP<110/70mmHg) and patients withhypotension（BP＜90/60mmHg）were compared and whose have the history ofhigh blood pressure, blood pressure was up to the standard were examined.Besides, different types of heart failure in patients of blood pressure difference;and hypotensive drugs utilized in patients with lower blood pressure onadmission and the effect of the drugs were examined.All data was analyzed with the statistical software SPSS17.0softwaresystem, P<0.05has significance for difference. Measurements data using themean value±standard deviation, Count data expressed in percentage.Meansof different groups were compared by t-test, terms between the two groupsapplied chi-square test. Results:242patients, with a mean age of63.4±12.72years, wereincluded in the analysis. The average blood pressure on admission(131.26±25.14/78.47±12.71mmHg) was lower than that at discharge (119.06±16.57/73.64±8.04mmHg)(P<0.05).The rate of hypertension was significantly decreased at dischargecompared with that on admission (14.88%vs45.46%) and the rate of patientswhose have the history of high blood pressure blood pressure was up to thestandard was evidently increased(79.63%vs33.33%) according to standard ofhypertension in JNC7. The compliance rate of blood pressure of discharge wasincreased (P<0.05)The rate of patients whose blood pressure was low (BP<110/70mmHg)on admission was increased when they discharged (26.45%vs27.27%). In thepatients whose BP was low on discharge, there were39.39%patients whoseBP was low at discharge was not low on admission.On admission SBP(<110mmHg), admission and discharge systolicblood pressure has no obvious difference (t=0.479, P>0.479); WhileDBP(<70mmHg) have risen8.40±8.30mm Hg, admission and dischargediastolic blood pressure has significant differences.(t=5.062, P <5.062).The rate of patients due to cardiovascular disease whose BP was low onadmission was higher than that in patients due to dilated cardiomyopathy(53.13%vs21.88%) and discharge(51.52%vs27.27%)，respectively atdischarge in patients whose BP less than110/70mmHg on discharge.(P＜0.05).There were2(0.83%)hypotensive patients on admission and6(2.48%) atdischarge. Discharge the proportion of low blood pressure is increased.The rate of drug therapy was20.83%for combining RAAS inhibitors、βblockers and diuretic、45.83%for combining RAAS inhibitors and diureticand8.33%for RAAS inhibitors singlely. There was no statistical differencefor blood pressure on admission and discharge between RAAS inhibitorsutilization and no RAAS inhibitors utilization. Conclusions:1The morbidity of hypertension is high in patients withheart failure on admission and the compliance rate of the admission bloodpressure in hypertensive patients was low. Blood pressure is admitted tohospital discharge decreases significantly, but there are20%patients bloodpressure falls below.2For heart failure patients with low blood pressure,discharge, than on proportion increase, there are a lot of low blood pressure onadmission is not even on the high side at discharge in patients with low bloodpressure. The rate of patients due to cardiovascular disease whose BP was lowon admission was higher than that in patients due to dilated cardiomyopathy.