Hong Seok Lee, Belen Nunez, Ferdinnd Visco, Savi Mushiyev and Gerald Pekler
The Joint National Committee (JNC) 8 hypertension guidelines were released in 2014 targeting higher blood pressure (BP) goals and it may allow the less antihypertensive medications. We will determine how BP was affected in different types of heart failure according to JNC 7, 8.732 patients enrolled in our heart failure program were analyzed retrospectively. And 688 patients who had been followed since March, 2014 were included. Based on ACC/AHA guidelines, heart failure is classified as a reduced ejection fraction (HFrEF, EF < 40), preserved ejection fraction (HFpEF, EF > 50) and heart failure with an improved ejection fraction (HFpEF (i), EF ≥ 40). 70.6% (486/688) patients were controlled based on the new guidelines, on the contrary, previous guideline revealed 58.7% BP control. Mean systolic BP was 128.9 ± 18 mmHg in heart failure with reduced EF and 125.1 ± 17 mmHg in heart failure with preserved EF. Obesity [Odds ratio (OR): 0.119, 95%, Confidence Interval (CI): 0.048-0.284], ACE inhibitor [OR: 2.659, 95% CI: 1.500-3.415] and Diuretics [OR: 1.904, 95%, CI: 1.068-3.394] were noted to significantly differentiate the controlled versus the uncontrolled BP group in reduced EF group. And obesity (BMI ≥ 30) was associated with BP control in HFrEF [OR: 0.180, 95% CI: 0.090-0.341]. The control rate according to JNC 8 was more increased compared to one based on JNC 7 even with the same medication. In each type of heart failure, there were medication related differences of risk factors related to BP control by two different guidelines. Patients may need change types of medication to control BP according to types of heart failure.
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