Association between Systolic Blood Pressure
and Congestive Heart Failure
in Hypertensive Patients
Mrs. Sutheera Intajarurnsan
Doctor of Public Health Student
Faculty of Public Health, Khon Kaen University
Outlines
Background Objectives Materials and Methods Results Discussions Conclusions
Background
As many as 1 billion people worldwide suffer from hypertension which estimated to cause 4.5% of current global disease burden
Of all the potential complications of hypertension, congestive heart failure (CHF) was the most consistently found, it is called
“Silent disease”
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Background (cont.)
Systolic blood pressure (SBP) is a major predictor of cardiovascular disease, one of complications in hypertensive (HT) patients
Gaps of knowledge:There are some controversial findings regarding
the association between SBP and risk of CHF.Moreover, not much epidemiologic evidence
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Objectives
To investigate the association between SBP and CHF among hypertensive patients in Thailand
Materials and Methods
Study designCross-sectional study
Based on the survey of the An Assessment on Quality of Care among Patients Diagnosed with Type 2 Diabetes (DM) and Hypertension (HT) Visiting Hospitals of Ministry of Public Health and Bangkok Metropolitan Administration in Thailand, from 2010 to 2012
Materials and Methods (cont.2)
Study outcomeAssociation between SBP and CHF
Independent variableSBP (polytomous categorical variables)
Dependent variableCHF (dichotomous categorical variables)
Materials and Methods (cont. 3)
Statistical analysisDescriptive analysisBivariate analysisMultivariate analysis (Multiple logistic regression)
All analyses were performed using Stata version 12.0 (Stata Corp, College Station, TX).
A p-value of less than 0.05 was considered statistical significant.
Results
Fig. 1. The inclusion flow chart
Results ; Characteristics
Gender
BMI
n= 38,429
Results ; Characteristics (cont. 2)
Smoking History
(*Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC); 7 th report, 2009.)n= 38,345
Results ; Factors associated with CHF complication in hypertensive patients
Fig. 2. Factors affecting CHF complication in hypertensive patients , presented as odds ratio adjusted for gender, age, occupation, BMI, SBP, DBP and smoking history, using multiple logistic regression
DiscussionsThis findings
The finding of this study showed that there were no significant associations between SBP and CHF complication among hypertensive patients (p = 0.223)
However, hypertensive patients who had high systolic blood pressure levels, were likely to obtained occurring of CHF complication.
These results likely presented the positive association but not significant difference
Discussions (cont. 2)
Previous findings
The Framingham Heart Study showed hypertension (SBP>140 mmHg) was associated with a two-fold increased risk of HF in men when compared with normal (SBP<140 mmHg)
The recently study was conducted by Kathryn A., and colleagues found a positive association between SBP and HF risk. Among subjects with a SBP 130-139 mmHg, there was a significantly increased risk of HF as well as a linear trend in HF risk across normotensive SBP categories6.
Discussions (cont. 3)
StrengthNationally representative sampleReal situations (uncontrolled conditions) Saving for time and budget
LimitationInsufficient data and missing values in medical
records (handle by using best case and worst case method compared with based case)
Information biasRecall bias
ConclusionsSystolic blood pressure was not significantly
associated with congestive heart failure in hypertensive patients.
Recommendations for the next study Further research should required lager sample size Design the study by using an RCT
Benefits Studies regarding risk and protective factors lead to
prevention of morbidity and mortality among HT patients.
Acknowledgements Collaborative partnerships of the Thailand National
Health Security Office (NHSO) and the Thailand Medical Research Network (MedResNet).
Prof. Dr. Bandit Thinkamrop Dr. Cameron Hurst
Miss Wilaiphorn Thinkamrop My seniors; especially Dr.PH batch 4
All my classmates; Dr.PH batch 5
Thank Youfor
Your Attention
