Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/110809
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Type: Journal article
Title: Long-term survival following the development of heart failure in an elderly hypertensive population
Author: Sahle, B.
Owen, A.
Wing, L.
Beilin, L.
Krum, H.
Reid, C.
Wing Chair, L.
Reid, C.
Beilin, L.
Brown, M.
Jennings, G.
Johnston, C.
McNeil, J.
Marley, J.
Morgan, T.
Ryan, P.
Shaw deceased, J.
West, M.
MacDonald, G.
Citation: Cardiovascular Therapeutics, 2017; 35(6):e12303
Publisher: Wiley
Issue Date: 2017
ISSN: 1755-5914
1755-5922
Statement of
Responsibility: 
Berhe W. Sahle, Alice J. Owen, Lindon M.H. Wing, Lawrence J. Beilin Henry Krum, Christopher M. Reid on behalf of the Second Australian National Blood Pressure Study Management Committee
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 re-mained 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.
Keywords: Elderly; epidemiology; heart failure; hypertension; survival; treated
Rights: © 2017 John Wiley & Sons Ltd.
RMID: 0030079011
DOI: 10.1111/1755-5922.12303
Grant ID: http://purl.org/au-research/grants/nhmrc/1092642
http://purl.org/au-research/grants/nhmrc/546272
Appears in Collections:Medicine publications

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