Predictor factors for the development of arterial hypertension following heart transplantation

Up to 95% of the patients with heart transplantation (HT) suffer from arterial hypertension (AHT). The development of de novo AHT after HT has not been greatly studied.

To identify the predictor variables for the development of de novo AHT after HT.

We retrospectively studied 253 patients with HT and who did not previously have AHT. We excluded cases of early mortality, re-transplants and combined transplants. We considered AHT as the constant need to take anti-hypertensive drugs to maintain blood pressure < 140/90 mmHg. We studied all the variables relating to recipient, donor, surgical procedure, immunosuppression and follow-up. The statistics used were the Student's t-test, chi-square statistic and a logistic regression analysis.

Of the 253 patients, 109 (43%) developed AHT. The variables associated with more prevalent AHT were male recipient/donor, idiopathic dilated cardiomyopathy (IDCM) as cause of HT, having been a smoker as well as renal deterioration (RD) and hypercholesterolemia after HT. The multivariate analysis found smoking prior to the HT and hypercholesterolemia during follow-up as independent risk factors and urgent HT as a protective variable.

AHT after HT is frequent. The variables associated in our population were smoking before HT, male recipient/donor, IDCM prior to HT and hypercholesterolemia and RD after HT.