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Association between Systolic Blood Pressure and Congestive Heart Failure

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

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Association between Systolic Blood Pressure and Congestive Heart Failure

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  1. 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

  2. Outlines • Background • Objectives • Materials and Methods • Results • Discussions • Conclusions

  3. Background http://isp.swanih.org • As many as 1 billion people worldwide suffer from hypertension whichestimated 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” http://www medical device network.com

  4. Background(cont.) http:// www. siamhealth.net • 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

  5. Objectives • To investigate the association between SBP and CHF among hypertensive patients in Thailand

  6. Materials and Methods • Study design • Cross-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

  7. Materials and Methods (cont.2) • Study outcome • Association between SBP and CHF • Independent variable • SBP (polytomous categorical variables) • Dependent variable • CHF (dichotomous categorical variables)

  8. Materials and Methods (cont. 3) • Statistical analysis • Descriptive analysis • Bivariate analysis • Multivariate 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.

  9. Results Fig. 1. The inclusion flow chart

  10. Results ; Characteristics Gender n= 38,429 BMI

  11. Results ; Characteristics (cont. 2) (*Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC); 7th report, 2009.) n= 38,345 Smoking History

  12. 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

  13. Discussions This 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

  14. 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.

  15. Discussions (cont. 3) • Strength • Nationally representative sample • Real situations (uncontrolled conditions) • Saving for time and budget • Limitation • Insufficient data and missing values in medical records (handle by using best case and worst case method compared with based case) • Information bias • Recall bias

  16. Conclusions Systolic 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.

  17. 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

  18. Thank Youfor Your Attention

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