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Survival differs between types of heart failure.

MUNICH -- Survival is significantly longer in patients with heart failure of hypertensive etiology than in those whose heart failure is secondary to ischemic heart disease, Lilian Grigorian, M.D., said at the annual congress of the European Society of Cardiology.

She presented a retrospective study of 702 patients with heart failure (HF) secondary to ischemic heart disease and 270 hypertensive HF patients with no clinical myocardial ischemia or valvular heart disease. All were admitted to the University of Santiago (Spain) Clinical Hospital during 1991-2002. Of patients in the ischemic heart disease group, 59% were also hypertensive.

Age and clinical severity of HF did not differ significantly between the two groups. Yet 5-year mortality in the group with HF and ischemic heart disease was 53%, compared with 44% in patients with HF with a hypertensive etiology. One-year mortality was 19% in patients with ischemic heart disease and 10% in those with purely hypertensive HF, Dr. Grigorian added.

There were several clinical differences between the two groups. The prevalence of atrial fibrillation was 40% among those with hypertensive HF and 21% in those with ischemic HF. Diabetes prevalence was 36% in patients with ischemic HF and 25% in those with hypertensive HF.

Hospitalization with acute pulmonary edema was an important marker for increased mortality risk in patients with ischemic HF, but not in those with hypertensive HF. Five-year mortality in patients without acute pulmonary edema at hospitalization was 45% in patients with hypertensive HF and 49% in those with ischemic heart disease. But 5-year mortality jumped to 78% in patients with ischemic HF hospitalized with acute pulmonary edema, while remaining at 42% in patients with hypertensive HF.

BY BRUCE JANCIN

Denver Bureau
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Title Annotation:Cardiovascular Medicine
Author:Jancin, Bruce
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:4EUSP
Date:Dec 15, 2004
Words:280
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