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. 2023 Feb 1;10(2):1280–1293. doi: 10.1002/ehf2.14275

Table 3.

Baseline characteristics of dose trajectories for RASi (angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers) groups at 6 months

Factor Stay low Up‐titrate Down‐titrate Stay high P value
N 439 82 34 236
Demographics
Age (years), mean (SD) 61.9 (13.2) 61.1 (12.9) 64.0 (10.6) 61.1 (11.9) 0.6
Women 70 (15.9%) 12 (14.6%) 8 (23.5%) 37 (15.7%) 0.67
Enrolled in SG (vs. NZ) 328 (74.7%) 41 (50.0%) 20 (58.8%) 106 (44.9%) <0.001
Enrolled as inpatient 260 (59.2%) 50 (61.0%) 22 (64.7%) 139 (58.9%) 0.92
History of prior HF hospitalization 273 (62.2%) 32 (39.0%) 18 (52.9%) 121 (51.3%) <0.001
Clinical exam/signs and symptoms
NYHA Class III/IV (vs. I/II) 99 (22.8%) 14 (17.1%) 10 (29.4%) 54 (23.2%) 0.5
BMI (kg/m2), mean (SD) 26.1 (5.1) 27.2 (5.5) 26.0 (4.9) 28.9 (6.6) <0.001
BSA (m2), mean (SD) 1.79 (0.22) 1.89 (0.22) 1.82 (0.24) 1.94 (0.26) <0.001
Systolic BP (mmHg), mean (SD) 116.2 (18.1) 124.0 (22.4) 123.8 (22.6) 123.7 (21.5) <0.001
Diastolic BP (mmHg), mean (SD) 70.1 (11.5) 75.4 (14.6) 72.3 (12.4) 74.6 (14.3) <0.001
Heart rate (b.p.m.), mean (SD) 77.7 (13.5) 73.6 (14.6) 76.4 (16.7) 74.4 (13.7) 0.007
LVEF (%), median (IQR) 25 (20, 30) 25 (23, 31) 30 (25, 34) 28 (22, 34) <0.001
Ischaemic aetiology 277 (63.1%) 35 (42.7%) 21 (61.8%) 118 (50.0%) <0.001
Shortness of breath on exertion 281 (64.2%) 51 (62.2%) 27 (79.4%) 165 (69.9%) 0.14
Shortness of breath at rest 62 (14.2%) 4 (4.9%) 4 (11.8%) 28 (11.9%) 0.13
Reduction in exercise tolerance 271 (61.7%) 52 (63.4%) 25 (73.5%) 165 (69.9%) 0.13
Orthopnoea 107 (24.4%) 17 (20.7%) 10 (29.4%) 56 (23.7%) 0.78
Paroxysmal nocturnal dyspnoea 72 (16.4%) 14 (17.1%) 10 (29.4%) 33 (14.0%) 0.16
Peripheral oedema 136 (31.2%) 24 (29.3%) 14 (41.2%) 81 (34.5%) 0.51
Laboratory values
NT‐proBNP (ng/L), median (IQR) 2314 (1223, 4507) 1745 (980, 4689) 3310 (1608, 7295) 1651 (851, 3946) 0.002
Potassium (mmol/L), median (IQR) 4.1 (3.7, 4.5) 4.0 (3.8, 4.3) 4.1 (3.8, 4.5) 4.1 (3.8, 4.5) 0.48
eGFR (mL/min/1.73 m2), median (IQR) 59.2 (47.0, 76.8) 67.4 (54.1, 83.4) 59.3 (40.8, 75.2) 58.2 (46.9, 72.7) 0.067
Medical history
Hypertension 239 (55.6%) 42 (51.9%) 28 (82.4%) 168 (72.1%) <0.001
Diabetes 202 (46.2%) 30 (36.6%) 13 (38.2%) 109 (46.2%) 0.34
Atrial fibrillation 131 (29.8%) 24 (29.3%) 12 (35.3%) 78 (33.1%) 0.77
Anaemia 142 (37.2%) 24 (30.8%) 14 (43.8%) 56 (25.9%) 0.022
Charlson comorbidity index, mean (SD) 2.3 (1.3) 2.1 (1.4) 2.6 (1.7) 2.5 (1.6) 0.078
Medications at baseline
Beta‐blockers at baseline 387 (88.6%) 74 (90.2%) 32 (94.1%) 213 (91.0%) 0.61
Beta‐blocker dose (%GRD) at baseline, median (IQR) 25 (13, 50) 25 (13, 50) 50 (25, 63) 50 (25, 63) <0.001
MRA at baseline 239 (54.4%) 39 (47.6%) 21 (61.8%) 123 (52.1%) 0.49
Loop diuretic at baseline 403 (91.8%) 74 (90.2%) 34 (100.0%) 222 (94.1%) 0.21
Statin at baseline 329 (74.9%) 55 (67.1%) 25 (73.5%) 175 (74.2%) 0.53
Outcomes
Composite outcome at 1 year 131 (29.8%) 16 (19.5%) 15 (44.1%) 66 (28.0%) 0.054

%GRD, per cent guideline‐recommended dose; BMI, body mass index; BP, blood pressure; BSA, body surface area; eGFR, estimated glomerular filtration rate; HF, heart failure; IQR, interquartile range; LVEF, left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonist; NT‐proBNP, N‐terminal pro‐beta‐type natriuretic peptide; NYHA, New York Heart Association; NZ, New Zealand; RASi, renin–angiotensin system inhibitor; SD, standard deviation; SG, Singapore.