Long-term survival following the development of heart failure in an elderly hypertensive population

Berhe W. Sahle, Alice J. Owen, Lindon M.H. Wing, Lawrence J. Beilin, Henry Krum, C. M. Reid, on behalf of the Second Australian National Blood Pressure Study Management Committee

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background: Available data on the prognosis of heart failure (HF) patients are predominantly limited to patients diagnosed at time of hospitalization. Aims: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second Australian National Blood Pressure Study (ANBP2) randomized 6083 hypertensive subjects aged 65-84 years to angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic–based therapy and followed them for a median of 4.1 years. One hundred forty-five participants who developed HF and 5938 who remained free from HF during the trial period were followed for a median of 6.7 years during a posttrial follow-up. Results: Three quarters, 110 (76%) of HF patients had died at the end of the follow-up. The five- and ten-year survival rates following HF diagnosis during the trial period were 37% and 15%, respectively, in men, compared with 60% and 33%, respectively, in women. In non–heart failure participants, the five- and ten-year survival rates, following enrollment into the study, were 92% and 76%, respectively. Mortality following HF diagnosis increased with advancing age (HR = 1.09, 95% CI: 1.04-1.33). In addition, male gender and preexisting diabetes were predictive of mortality, while ACE inhibitor–based therapy for the initial trial was associated with 39% decrease (HR = 0.61, 95% CI: 0.41-0.91) in mortality compared with a thiazide diuretic–based regimen. Conclusions: Long-term survival in elderly HF patients is poor, especially in men. Mortality in HF patients increased progressively with advancing age, while allocation to the ACE inhibitor–based regimen for the initial trial significantly improved HF outcome.

Original languageEnglish
Article numbere12303
Number of pages8
JournalCardiovascular Therapeutics
Volume35
Issue number6
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • Elderly
  • Epidemiology
  • Heart failure
  • Hypertension
  • Survival
  • Treated

Cite this

Sahle, B. W., Owen, A. J., Wing, L. M. H., Beilin, L. J., Krum, H., Reid, C. M., & on behalf of the Second Australian National Blood Pressure Study Management Committee (2017). Long-term survival following the development of heart failure in an elderly hypertensive population. Cardiovascular Therapeutics, 35(6), [e12303]. https://doi.org/10.1111/1755-5922.12303
Sahle, Berhe W. ; Owen, Alice J. ; Wing, Lindon M.H. ; Beilin, Lawrence J. ; Krum, Henry ; Reid, C. M. ; on behalf of the Second Australian National Blood Pressure Study Management Committee. / Long-term survival following the development of heart failure in an elderly hypertensive population. In: Cardiovascular Therapeutics. 2017 ; Vol. 35, No. 6.
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title = "Long-term survival following the development of heart failure in an elderly hypertensive population",
abstract = "Background: Available data on the prognosis of heart failure (HF) patients are predominantly limited to patients diagnosed at time of hospitalization. Aims: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second Australian National Blood Pressure Study (ANBP2) randomized 6083 hypertensive subjects aged 65-84 years to angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic–based therapy and followed them for a median of 4.1 years. One hundred forty-five participants who developed HF and 5938 who remained free from HF during the trial period were followed for a median of 6.7 years during a posttrial follow-up. Results: Three quarters, 110 (76{\%}) of HF patients had died at the end of the follow-up. The five- and ten-year survival rates following HF diagnosis during the trial period were 37{\%} and 15{\%}, respectively, in men, compared with 60{\%} and 33{\%}, respectively, in women. In non–heart failure participants, the five- and ten-year survival rates, following enrollment into the study, were 92{\%} and 76{\%}, respectively. Mortality following HF diagnosis increased with advancing age (HR = 1.09, 95{\%} CI: 1.04-1.33). In addition, male gender and preexisting diabetes were predictive of mortality, while ACE inhibitor–based therapy for the initial trial was associated with 39{\%} decrease (HR = 0.61, 95{\%} CI: 0.41-0.91) in mortality compared with a thiazide diuretic–based regimen. Conclusions: Long-term survival in elderly HF patients is poor, especially in men. Mortality in HF patients increased progressively with advancing age, while allocation to the ACE inhibitor–based regimen for the initial trial significantly improved HF outcome.",
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author = "Sahle, {Berhe W.} and Owen, {Alice J.} and Wing, {Lindon M.H.} and Beilin, {Lawrence J.} and Henry Krum and Reid, {C. M.} and {on behalf of the Second Australian National Blood Pressure Study Management Committee}",
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Sahle, BW, Owen, AJ, Wing, LMH, Beilin, LJ, Krum, H, Reid, CM & on behalf of the Second Australian National Blood Pressure Study Management Committee 2017, 'Long-term survival following the development of heart failure in an elderly hypertensive population', Cardiovascular Therapeutics, vol. 35, no. 6, e12303. https://doi.org/10.1111/1755-5922.12303

Long-term survival following the development of heart failure in an elderly hypertensive population. / Sahle, Berhe W.; Owen, Alice J.; Wing, Lindon M.H.; Beilin, Lawrence J.; Krum, Henry; Reid, C. M.; on behalf of the Second Australian National Blood Pressure Study Management Committee.

In: Cardiovascular Therapeutics, Vol. 35, No. 6, e12303, 01.12.2017.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Long-term survival following the development of heart failure in an elderly hypertensive population

AU - Sahle, Berhe W.

AU - Owen, Alice J.

AU - Wing, Lindon M.H.

AU - Beilin, Lawrence J.

AU - Krum, Henry

AU - Reid, C. M.

AU - on behalf of the Second Australian National Blood Pressure Study Management Committee

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Y1 - 2017/12/1

N2 - Background: Available data on the prognosis of heart failure (HF) patients are predominantly limited to patients diagnosed at time of hospitalization. Aims: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second Australian National Blood Pressure Study (ANBP2) randomized 6083 hypertensive subjects aged 65-84 years to angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic–based therapy and followed them for a median of 4.1 years. One hundred forty-five participants who developed HF and 5938 who remained free from HF during the trial period were followed for a median of 6.7 years during a posttrial follow-up. Results: Three quarters, 110 (76%) of HF patients had died at the end of the follow-up. The five- and ten-year survival rates following HF diagnosis during the trial period were 37% and 15%, respectively, in men, compared with 60% and 33%, respectively, in women. In non–heart failure participants, the five- and ten-year survival rates, following enrollment into the study, were 92% and 76%, respectively. Mortality following HF diagnosis increased with advancing age (HR = 1.09, 95% CI: 1.04-1.33). In addition, male gender and preexisting diabetes were predictive of mortality, while ACE inhibitor–based therapy for the initial trial was associated with 39% decrease (HR = 0.61, 95% CI: 0.41-0.91) in mortality compared with a thiazide diuretic–based regimen. Conclusions: Long-term survival in elderly HF patients is poor, especially in men. Mortality in HF patients increased progressively with advancing age, while allocation to the ACE inhibitor–based regimen for the initial trial significantly improved HF outcome.

AB - Background: Available data on the prognosis of heart failure (HF) patients are predominantly limited to patients diagnosed at time of hospitalization. Aims: To describe the long-term survival of incident HF patients and identify clinical characteristics associated with mortality. Methods: The Second Australian National Blood Pressure Study (ANBP2) randomized 6083 hypertensive subjects aged 65-84 years to angiotensin-converting enzyme (ACE) inhibitor or thiazide diuretic–based therapy and followed them for a median of 4.1 years. One hundred forty-five participants who developed HF and 5938 who remained free from HF during the trial period were followed for a median of 6.7 years during a posttrial follow-up. Results: Three quarters, 110 (76%) of HF patients had died at the end of the follow-up. The five- and ten-year survival rates following HF diagnosis during the trial period were 37% and 15%, respectively, in men, compared with 60% and 33%, respectively, in women. In non–heart failure participants, the five- and ten-year survival rates, following enrollment into the study, were 92% and 76%, respectively. Mortality following HF diagnosis increased with advancing age (HR = 1.09, 95% CI: 1.04-1.33). In addition, male gender and preexisting diabetes were predictive of mortality, while ACE inhibitor–based therapy for the initial trial was associated with 39% decrease (HR = 0.61, 95% CI: 0.41-0.91) in mortality compared with a thiazide diuretic–based regimen. Conclusions: Long-term survival in elderly HF patients is poor, especially in men. Mortality in HF patients increased progressively with advancing age, while allocation to the ACE inhibitor–based regimen for the initial trial significantly improved HF outcome.

KW - Elderly

KW - Epidemiology

KW - Heart failure

KW - Hypertension

KW - Survival

KW - Treated

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DO - 10.1111/1755-5922.12303

M3 - Article

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JO - Cardiovascular Therapeutics

JF - Cardiovascular Therapeutics

SN - 1755-5914

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