Low blood pressure and preserved systolic function in elders with heart failure

Abstract

This literature review was performed to evaluate the relationship of systolic blood pressure (SBP) and preserved systolic function on morbidity and mortality in individuals older than 65 years with heart failure (HF). When prolonged, high SBP, defined as measurements greater than 140 to 160 mm Hg, is associated with increased risk of developing HF. Medications to lower SBP measurements to Joint National Committee VII goals of less than 140 mm Hg are often prescribed on the assumption that treatment guidelines result from a systematic analysis of clinical trials and efficacy of drug treatments. Lower limits of SBP are less defined in current guidelines optimizing HF. The electronic databases PubMed, CINAHL, and Google Scholar are searched for keywords heart failure, prognosis, preserved systolic function, and blood pressure (BP). Five scholarly research articles investigated the effects of variables, notably SBP and confirmed preserved systolic function, on HF, published in the English language between July 2006 and January 2009. Inclusion criteria were study samples consisting of individuals 65 years and older referred in this article as elders, with the diagnosis of HF with a focus on variables measuring SBP and systolic function when assessing outcomes. Low SBP is a risk factor for adverse outcomes in HF elders. Additionally, female elders more commonly had preserved systolic function, but presented with less classic symptoms of HF and were less likely to receive cardiology consultation. Considerations for future research are the inclusion of participants presenting with SBP of less than 110 mm Hg in clinical trials and updated evidence-based guidelines, defining acceptable increased target BP ranges, for sex- and age-adjusted HF patients with preserved systolic function.