Prognostic value of long‐term blood pressure changes in patients with chronic heart failure

Background Chronic heart failure (CHF) is the final stage of many heart diseases. To improve outcomes, important risk factors for adverse clinical events in the CHF population need to be identified. The aim of the present study was to delineate the influence of long‐term blood pressure (BP) changes on prognosis and mortality in a real‐world cohort of CHF patients. Methods and results This is a retrospective longitudinal analysis. Repeated office BP measurements were scheduled during follow‐up visits every 3–6 months. The primary endpoint was time to death or heart transplantation (HTx). A Cox regression with time‐dependent strata was used to analyse the effect of systolic BP (SBP) values and its change during follow‐up on the primary endpoint. A total of 927 patients presented with a median survival of 7.7 [95% confidence interval (CI) 6.6–9.8] years. During follow‐up, 220 patients died and 70 patients underwent HTx. The BP stratum with the most stable values showed the best survival. Blood pressure changes with an increase or decrease greater than ±10 mmHg per year led to a significantly worse outcome [hazard ratio (HR) 1.8 and 2.0, respectively]. The stratum with the lowest SBP levels (