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There are no previous studies regarding the predictive value of DBP in elderly patients with HF with preserved ejection fraction (HFpEF) in Japan. This study aimed to investigate the prognostic significance of DBP in patients with acute decompensated HFpEF. We analyzed data of all HFpEF patients admitted to Shinonoi General Hospital for HF treatment between July 2016 and December 2018. We excluded patients with acute coronary syndrome and severe valvular disease. Patients were divided into two groups according to their median DBP; the low DBP group (DBP\u2009\u2264\u200977\u00a0mmHg,<jats:italic>n<\/jats:italic>\u2009=\u2009106) and the high DBP group (DBP\u2009&gt;\u200977\u00a0mmHg,<jats:italic>n<\/jats:italic>\u2009=\u2009100). The primary outcome was HF readmission. In 206 enrolled patients (median 86\u00a0years), during a median follow-up of 302\u00a0days, the primary outcome occurred in 48 patients. The incidence of HF readmission was significantly higher in the low DBP group (33.0% vs 18.5%,<jats:italic>p<\/jats:italic>\u2009=\u20090.024). In Kaplan\u2013Meier analysis, low DBP predicted HF readmission (Log-rank test,<jats:italic>p<\/jats:italic>\u2009=\u20090.013). In Cox proportional hazard analysis, low DBP was an independent predictor of HF readmission after adjustment for age, sex, SBP, hemoglobin, serum albumin, serum creatinine, B-type natriuretic peptide, renin-angiotensin system inhibitors, calcium channel blockers, left ventricular ejection fraction, coronary artery disease, and whether they live alone (hazard ratio, 2.229; 95% confidence interval, 1.021\u20134.867;<jats:italic>p<\/jats:italic>\u2009=\u20090.044). Low DBP predicted HF readmission in patients with HFpEF.<\/jats:p>","DOI":"10.1007\/s00380-021-01788-0","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T09:08:41Z","timestamp":1612256921000},"page":"1159-1165","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prognostic significance of diastolic blood pressure in patients with heart failure with preserved ejection fraction"],"prefix":"10.1007","volume":"36","author":[{"given":"Aya","family":"Fuchida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9058-9258","authenticated-orcid":false,"given":"Sho","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohiko","family":"Motoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kanzaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Hashizume","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Kozuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumiko","family":"Yahikozawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Kuwahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"1788_CR1","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1253\/circj.72.489","volume":"72","author":"Y Okura","year":"2008","unstructured":"Okura Y, Ramadan MM, Ohno Y, Mitsuma W, Tanaka K, Ito M, Suzuki K, Tanabe N, Kodama M, Aizawa Y (2008) Impending epidemic: future projection of heart failure in Japan to the year 2055. 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