Heart failure & cardiomyopathiesMeta-analysis
Phenotype-specific prognostic implications of pulse pressure in heart failure
- Pooled patient-level analysis of randomised trials
- 13 randomised HF trials
Authors' conclusion
PP has phenotype-specific prognostic implications in HF. Low PP identifies higher risk in HFrEF, whereas high PP identifies higher risk in HFpEF and HFmrEF.
Study context
- Population
- Patients with HF (HFrEF, HFmrEF, HFpEF) in 13 randomised HF trials13 RCTs
- Participants
- 35,550 / 6,484 / 19,173
- Comparison
- Pulse pressure (PP) quartiles across HF phenotypes
- HFrEFn = 35,550
- HFmrEFn = 6,484
- HFpEFn = 19,173
- Outcome
- First HF hospitalization or CV death
Pooled result
As reported in the abstract
First HF hospitalization or CV death, by PP quartile
| Group | Highest PP quartile (>56 mmHg) | Lowest PP quartile (<40 mmHg) | Second PP quartile (48-56 mmHg) | Fourth PP quartile (> 66 mmHg) |
|---|---|---|---|---|
| HFrEF | 13.3 per 100 person-years (95% CI, 12.8-13.8) | 18.2 (17.5-18.9) | ||
| HFpEF | 6.8 (6.4-7.3) | 9.7 (9.1-10.3) |
Further pooled results
Incremental prognostic value of PP beyond SBP
- PP improved model fit beyond SBP; small improvement in discrimination, largely limited to HF hospitalization-related outcomes in HFpEF
Original publication
Phenotype-specific prognostic implications of pulse pressure in heart failure. Eur J Heart Fail. Published 11 September 2026. doi:10.1093/ejhf/xuag292
Summarised from the published abstract; every number is checked against it