Scholarlink

Objective <p>This study aimed to investigate the correlation between the in-hospital intensity of pharmacologic blood pressure–lowering therapy and improvement in cardiac function in patients with acutely decompensated chronic heart failure (ADCHF) and essential hypertension.</p> Methods <p>A single-center retrospective cohort study was conducted. We enrolled 517 inpatients: 257 in HF group (ADCHF with hypertension) and 260 served as controls (hypertension with normal cardiac function). The primary exposure was the change in Therapeutic Intensity Score (ΔTIS) from admission to discharge, calculated by summing the prescribed-to-maximum dose ratios of all medications with blood pressure–lowering effects. The primary outcome was the change in N-terminal pro-B-type natriuretic peptide (ΔNT-proBNP). Subgroup analyses were performed by left ventricular ejection fraction (LVEF) categories and hypertension characteristics. Associations were assessed using Spearman correlation and multivariable linear regression, adjusting for key clinical covariates.</p> Results <p>At admission, the HF group had a lower median TIS than controls (0.50 vs. 0.75, <i>p</i> &lt; 0.001), indicating a potential gap in baseline management. During hospitalization, TIS increased significantly within the HF cohort. This treatment intensification (ΔTIS) showed a positive and independent correlation with the reduction in NT-proBNP (ΔNT-proBNP) (β = 0.384, 95% CI 0.108–0.660, <i>p</i> = 0.007), adjusting for age, LVEF, and other covariates. The association was consistent across heart failure phenotypes defined by LVEF. Furthermore, patients with heart failure with preserved ejection fraction (HFpEF) required a higher discharge TIS than controls with similar LVEF (1.125 vs. 0.750, <i>p</i> &lt; 0.001).</p> Conclusion <p>In patients with ADCHF and hypertension, in-hospital intensification of pharmacologic pressure-lowering therapy, quantified by ΔTIS, is associated with acute improvement in cardiac load, as reflected by NT-proBNP reduction. The TIS provides a standardized metric to quantify this treatment escalation, highlighting its potential utility for structured management. Prospective studies are warranted to determine if TIS-guided therapy improves long-term clinical outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Correlation between pharmacologic blood pressure–lowering intensity and improvement in cardiac function in patients with acutely decompensated heart failure

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月11日

查看全文
  • Zhe Zhang,
  • Zeyuan Fan,
  • Yan Liu,
  • Limin Han

摘要

Objective

This study aimed to investigate the correlation between the in-hospital intensity of pharmacologic blood pressure–lowering therapy and improvement in cardiac function in patients with acutely decompensated chronic heart failure (ADCHF) and essential hypertension.

Methods

A single-center retrospective cohort study was conducted. We enrolled 517 inpatients: 257 in HF group (ADCHF with hypertension) and 260 served as controls (hypertension with normal cardiac function). The primary exposure was the change in Therapeutic Intensity Score (ΔTIS) from admission to discharge, calculated by summing the prescribed-to-maximum dose ratios of all medications with blood pressure–lowering effects. The primary outcome was the change in N-terminal pro-B-type natriuretic peptide (ΔNT-proBNP). Subgroup analyses were performed by left ventricular ejection fraction (LVEF) categories and hypertension characteristics. Associations were assessed using Spearman correlation and multivariable linear regression, adjusting for key clinical covariates.

Results

At admission, the HF group had a lower median TIS than controls (0.50 vs. 0.75, p < 0.001), indicating a potential gap in baseline management. During hospitalization, TIS increased significantly within the HF cohort. This treatment intensification (ΔTIS) showed a positive and independent correlation with the reduction in NT-proBNP (ΔNT-proBNP) (β = 0.384, 95% CI 0.108–0.660, p = 0.007), adjusting for age, LVEF, and other covariates. The association was consistent across heart failure phenotypes defined by LVEF. Furthermore, patients with heart failure with preserved ejection fraction (HFpEF) required a higher discharge TIS than controls with similar LVEF (1.125 vs. 0.750, p < 0.001).

Conclusion

In patients with ADCHF and hypertension, in-hospital intensification of pharmacologic pressure-lowering therapy, quantified by ΔTIS, is associated with acute improvement in cardiac load, as reflected by NT-proBNP reduction. The TIS provides a standardized metric to quantify this treatment escalation, highlighting its potential utility for structured management. Prospective studies are warranted to determine if TIS-guided therapy improves long-term clinical outcomes.