Effect of different diastolic blood pressure levels on the prognosis of patients with heart failure after acute myocardial infarction.

Aims: This study aims to investigate the effect of different diastolic blood pressure levels at discharge on the prognosis of patients with heart failure after acute myocardial infarction. Methods: This study included 642 patients hospitalized in the Department of Cardiology of Langfang People's Hospital who were diagnosed with heart failure after acute myocardial infarction between March 2017 and October 2022. Patients were divided according to diastolic blood pressure (DBP) at discharge into three groups: <70 mmHg ( Results: During the follow-up period, there were no significant differences among the three groups in the incidence of the primary endpoint (a composite of all-cause mortality and all-cause readmission) or secondary endpoints (the composite endpoint of cardiac death and cardiac readmission, all-cause mortality, cardiac death, all-cause readmission, cardiac readmission, and heart failure readmission) ( Conclusion: Different DBP levels at discharge in patients with heart failure after AMI are useful for patient prognosis evaluation. Maybe patients with heart failure after AMI with a low DBP (<70 mmHg) at discharge have a lower risk of all-cause mortality and all-cause readmission. Notably, the study population had a relatively high mean left ventricular ejection fraction, and a higher number of patients in the DBP < 70 mmHg group were treated with MRAs. Since MRAs themselves have blood pressure-lowering effects, their use may have influenced the results and prognosis. Therefore, until these findings are confirmed by further trials, active reduction of diastolic blood pressure should be approached with caution. This conclusion requires validation through large-scale randomized studies.