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Prognostic value of combined target-organ damage in patients with essential hypertension

Gerardo Carpinella1, Gennaro Pagano1, Francesco Buono1

  • 1Dipartimento Scienze Mediche Traslazionali, Università Federico II, Naples, Italy;

American Journal of Hypertension
|June 18, 2014
PubMed

Insights

The combination of left ventricular hypertrophy (LVH) and chronic kidney disease (CKD) significantly increases cardiovascular risk in patients with hypertension. This highlights the importance of considering combined target-organ damage for accurate risk assessment.

Area of Science:

  • Cardiology
  • Nephrology
  • Hypertension Research

Background:

  • Cardiovascular (CV) risk in hypertension is influenced by target-organ damage (TOD).
  • The combined impact of left ventricular hypertrophy (LVH) and chronic kidney disease (CKD) on CV risk in uncomplicated hypertension is not well-understood.
  • This study investigates the synergistic effects of LVH and CKD on CV events in hypertensive patients.

Purpose of the Study:

  • To assess the individual and combined effects of LVH and CKD on cardiovascular event risk.
  • To evaluate the role of combined LVH and CKD in cardiovascular risk stratification among hypertensive individuals.

Main Methods:

  • Analysis of 1,078 patients with essential hypertension.
  • Prospective follow-up for a median of 84 months to record cardiovascular events.
  • Multivariable Cox proportional hazard analysis to determine the association of LVH and CKD with CV events, adjusting for various factors.

Main Results:

  • LVH was present in 9.6%, CKD in 51.5%, and combined LVH+CKD in 16.1% of patients.
  • The combined presence of LVH and CKD significantly increased the hazard ratio for CV events (HR=2.45, P=0.03) after adjustment for age and sex.
  • This association remained significant when adjusted for one CV risk factor (HR=3.226, P=0.02) but lost significance with two or more risk factors.

Conclusions:

  • The combination of LVH and CKD is a significant predictor of cardiovascular events in hypertensive patients.
  • Interactions between target-organ damage and other risk factors are crucial for CV risk stratification.
  • Clinicians should consider the presence of both LVH and CKD for comprehensive risk assessment in hypertension management.
Abstract

Keywords:
blood pressurecardiovascular riskchronic kidney diseaseessential hypertensionhypertensionleft ventricular hypertrophymyocardial infarctionstroke

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