Low Blood Pressure Bad for Heart Failure Patients

A new study by US researchers has found heart patients with low blood pressure to be at a higher risk of dying. The results contradict current medical belief that low blood pressure in heart failure patients is a good sign.

Following their study, the researchers are advising doctors to consider low or even normal blood pressure to be a sign of advanced disease in heart failure patients. The results of the study appear in the latest issue of the Journal of the American Medical Association.

Records of 48,612 heart failure patients were studied for the study. The patients were treated at 259 hospitals in the US between March 2003 and December 2004. Analysis of the records revealed lower death rates in patients with higher systolic blood pressures than in patients with lower blood pressure. The figures held true while patients were in hospital and even after they were discharged.

Systolic blood pressure is the highest number in the reading of blood pressure and depicts the pressure on the arteries at the time of contraction of the heart. Systolic blood pressure is considered normal when it reads 120 while any reading above 140 is considered very high. “The lower the admission systolic blood pressure level, the higher the patient mortality rate,” said Dr. Mihai Gheorghiade of Northwestern University in Chicago, who led the study.

A patient suffers from heart failure when the heart fails to pump blood properly. Failure to pump blood leads to an enlargement of the heart and pooling of blood around the organ. This in turn leads to congestion and occasionally a cough.

Heart failure kills nearly 50% of all patients within five years of diagnosis with nearly 500,000 new patients being diagnosed with the condition each year in the US alone. Nearly a million Americans get admitted to hospitals each year due to heart failure.

“I think going back to the basics and really looking at things like blood pressure, it shows that it’s still important to look at the basics of the physical exam,” said Dr. William Cotts of Northwestern Memorial Hospital, who worked on the study. According to Dr. Gheorghiade, heart failure patients may actually benefit from a temporary increase in their blood pressure.

“During stress, or at the time of admission, it appears that when you have high blood pressure for a limited amount of time, let’s say hours, that may indicate that your heart is stronger,” he said. “So it’s not that the high blood pressure is good, but it’s a measure of the strength of the heart.”

Heart failure may be caused by a number of reasons including high blood pressure, viral infections and valve disease. Currently heart transplantation is the best known cure in most cases. However symptoms of the condition may be brought under control through blood pressure-lowering medications and other heart drugs.

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