Predictive Value Of Ambulatory Blood Pressure Monitoring In Readmission Rate Of Elderly Patients With Congestive Heart Failure

Objective:To explore the relationship between the characteristics of ambulatory blood pressure in elderly patients with congestive heart failure(CHF) and readmission.Methods:(1) A total of 70 patients with CHF(NYHA Ⅲ, Ⅳ) and hypertension(median age 76.73±7.02 yrs old), were treated by standard heart failure therapy and antihypertensive therapy. All the patients had ambulatory blood pressure monitored upon discharge.(2) The patients’general information and ambulatory blood pressure parameters were collected. The following parameters were observed: 24-hour mean arterial blood pressure(24h MBP)、24-hour mean systolic blood pressure(24h SBP)、24h-hour mean diastolic blood pressure(24h DBP)、daytime systolic blood pressure(DSBP)、daytime diastolic blood pressure(DDBP、nighttime systolic blood pressure(NSBP)、nighttime diastolic blood pressure(NDBP) as a representative of blood pressure stability index, systolic blood pressure load ratio、diastolic blood pressure load ratio as a representative of blood pressure load indicators and blood pressure rhythm disorders ratio as a representative of blood pressure variability index.(3) All the patients were divided into Blood Pressure Controlled group and Non-controlled group according to 24h MBP、24hSBP,24hDBP、 DSBP、DDBP、NSBP、NDBP、Systolic blood pressure load ratio、 Diastolic blood pressure load ratio or blood pressure rhythm disorders ratio. The readmission rate between the two groups was compared.Results:(1)Compared with the Non-controlled group, the BP controlled group of 24hMBP、24hSBP、24hDBP、DSBP、DDBP、NSBP or NDBP had a lower readmission rate. And the readmission rate of BP controlled group of 24hSBP、24hDBP、DSBP or NSBP was obviously lower than that of the Non-controlled group(p<0.05).(2)The readmission rate of Controlled group of blood pressure load ratio was lower than that of the Non-controlled group, but not statistically different(p>0.05).(3)The readmission rate of Non-controlled group of blood pressure rhythm disorders ratio was higher than that of the controlled group(p< 0.05).Conclusion:(1)Improving the ratio of the standard blood pressure, reducing the blood pressure circadian rhythm disorders ratio can decrease the readmission rate of the elderly patients with hypertension and CHF.(2)The ambulatory blood pressure monitoring in elderly patients with CHF and hypertension can help understand the prognosis and guide clinical treatment.