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Left ventricular hypertrophy and renal dysfunction during antihypertensive treatment adversely affect cardiovascular

Massimo Salvetti1, Maria L Muiesan, Anna Paini

  • 1Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.

Journal of Hypertension
|December 20, 2011
PubMed

Insights

In hypertensive patients, persistent or developing chronic kidney disease (CKD) and left ventricular hypertrophy (LVH) independently predict cardiovascular events. Monitoring both renal function and cardiac structure is crucial for prognosis.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Hypertension significantly increases cardiovascular event risk.
  • Chronic kidney disease (CKD) and left ventricular hypertrophy (LVH) are independent prognostic factors for cardiovascular events.
  • The dynamic relationship between renal function, cardiac structure, and cardiovascular prognosis in hypertensive patients requires further elucidation.

Purpose of the Study:

  • To investigate the association between renal and cardiac target-organ damage at baseline and during treatment in hypertensive patients.
  • To assess the influence of changes in renal function and cardiac structure on cardiovascular prognosis.
  • To identify independent predictors of cardiovascular events in hypertensive individuals.

Main Methods:

  • A cohort of 436 uncomplicated hypertensive patients was analyzed.
  • 246 patients with serial echocardiogram and creatinine measurements were followed for an average of 55 months.
  • Cardiovascular events were recorded after the final follow-up examination.

Main Results:

  • Persistence or development of LVH was associated with a 2.36-fold increased risk of cardiovascular events.
  • Persistence or development of CKD (eGFR <60 ml/min) was linked to a 1.94-fold increased risk.
  • Both LVH and CKD were identified as independent predictors of cardiovascular events by multivariate Cox regression analysis.

Conclusions:

  • In hypertensive patients without prior cardiovascular disease, sustained or emerging reduced renal function is a significant prognostic factor.
  • Persistence or development of left ventricular hypertrophy also independently predicts cardiovascular events in this population.
  • Monitoring both renal function and cardiac structure is essential for risk stratification in hypertensive patients.
Abstract

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