DOI: https://doi.org/10.22141/2224-1485.2.58.2018.131068

Risk factors influencing the prognosis in patients with arterial hypertension

Yu.M. Sirenko, G.D. Radchenko, O.L. Rekovets

Abstract


524 patients, who were treated in specialized secondary hypertension unit, were included in 5-year reprospective analysis. All patients during hospital stay underwent standard examination: office blood pressure measurement, electrocardiography (ECG), echocardiography, blood pressure monitoring. After 5 years, all patients were mailed questionnaires, on which they answered by themselves. In case of patients death, their relatives answered. Mantel-Haenszel and Cox regression univariate and multivariate analysis was performed to detect independent risk factors for combined end-point (myocardial infarction, unstable angina, stroke, new heart failure, new renal failure, death, new diabetes mellitus, other cardiovascular events — coronary artery bypass graft, aortic aneurysm, etc.). The study found that main risk factors of end-point development were age, systolic (> 160 mmHg) and pulse (> 64 mmHg) blood pressure at the time of discharge from hospital, myocardial infarction and stroke/ transient ischemic attack in the past medical history, enlarged left atrium, decreased ejection fraction (less than 40 %), increased interventricular septum thickness (> 1.2 cm), left ventricular mass index > 137 g/m2 , ECG signs of left ventricular hypertrophy (Estes > 3), daily index < 10 % (non-dippers) and day time pulse pressure > 64 mmHg during blood pressure monitoring. Among indicated factors, independent ones were office pulse pressure > 64 mmHg, ejection fraction < 40 %, increased interventricular septum thickness (> 1.2 cm), left ventricular mass index > 137 g/m2 , ECG signs of left ventricular hypertrophy (Estes > 3), daily index < 10 % (non-dippers) and daytime pulse pressure > 64 mmHg during blood pressure monitoring. Such risk factors as office pulse pressure, decreased ejection fraction, non-dipper blood pressure profile and increased daytime pulse pressure saved their influence on prognosis independently from antihypertensive therapy. We did not find the benefits of any antihypertensive drug groups. Only level of blood pressure reduction (especial pulse pressure) was important for prognosis.

Keywords


arterial hypertension; prognosis; risk factors

References


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