Low admission pulse pressure and increased in-hospital mortality in patients with heart failure

By
Liying Zhong
Meng Wei
Xianhui Zhou
April 30, 2026
0 min

Frontiers In Cardiovascular Medicine

Overview

Revise to include methodology details and emphasize the independent nature of pulse pressure.

Background

Heart failure (HF) presents a significant healthcare challenge due to its high in-hospital mortality rates and associated healthcare costs. Identifying patients at high risk for adverse outcomes during hospitalization is crucial for improving management strategies. Pulse pressure, a readily available clinical measure, has been shown to correlate with various cardiovascular risks, yet its role in predicting in-hospital mortality in HF patients has not been fully explored.

Data Highlights

Measure	Outcome	Odds Ratio (OR)	95% Confidence Interval (CI)
PP < 30 mmHg	All-cause mortality	1.31	1.06–1.60
PP < 30 mmHg	Cardiac death	1.80	1.38–2.35

Key Findings

1,541 out of 21,768 heart failure patients (7.1%) experienced in-hospital mortality.
Admission PP < 30 mmHg was independently associated with increased all-cause mortality and cardiac death.
Lower PP (<50 mmHg) correlated with higher risks of in-hospital mortality across different left-ventricular ejection fraction (LVEF) phenotypes.
The relationship between PP and in-hospital mortality was consistent across LVEF strata.
Integration of PP into risk stratification could improve patient monitoring and management.

Clinical Implications

Clinicians should consider admission pulse pressure as a critical parameter in assessing the risk of in-hospital mortality in heart failure patients. Early identification of patients with low PP can facilitate timely interventions and potentially improve outcomes.

Conclusion

Low admission pulse pressure is a significant predictor of in-hospital mortality in heart failure patients, highlighting the need for its inclusion in clinical risk assessment protocols.