Table 1:

Inclusion and exclusion criteria

Inclusion Criteria

Age ≥ 55 years old

History of systemic hypertension

Patient being discharged to home

Admission for acute decompensated HF, with criteria:

≥ 1 symptom of HF:

• dyspnea, fatigue, orthopnea, PND

≥ 2 signs of HF:

• pulmonary congestion on exam or chest x-ray, jugular venous distension, edema or rapid weight gain, elevated BNP (>100 pg/ml)

Change in medical treatment specifically targeting HF:

• diuretics, vasodilators, and/or neurohormonal agents

No other apparent cause of patient’s signs and symptoms

Exclusion Criteria

Hypotension during hospitalization:
persistent systolic BP <100

Hyperkalemia:

• ≥ 2 serum potassium > 5.0 mmol/L during hospitalization

• History serum potassium > 6.0 mmol/L

Severe anemia (hemoglobin < 9.0 g/dL)

Length of stay < 48 hours or > 14 days

Expected survival < 12 months

Active alcohol or substance abuse

Dementia or history of nonadherence to treatment

Exclusions at Discharge:

Blood pressure (persistent within 24 hr prior to discharge):

• Systolic BP > 180 mmHg or diastolic BP > 100 mmHg

• Hypotension (persistent systolic BP < 110 mmHg)

Need for intravenous inotropic therapy

Severe renal insufficiency (eGFR < 30 ml/min/1.73 m²)