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Prognostic factors in treated hypertension
O Samuelsson1, L Wilhelmsen, K Pennert
1University of Gothenburg, Department of Medicine I, Sahlgrenska Hospital, Sweden.
Insights
Even treated hypertensive men face substantial cardiovascular disease (CVD) risk if other factors like high blood pressure or smoking are present. Multiple risk factor intervention is crucial for managing CVD in these patients.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality and morbidity.
- Hypertension is a major modifiable risk factor for CVD.
- Effective management of hypertension is essential for reducing cardiovascular events.
Purpose of the Study:
- To identify prognostic factors for cardiovascular disease (CVD) and coronary heart disease (CHD) in treated, middle-aged male hypertensives.
- To analyze the impact of baseline clinical characteristics on long-term CVD risk.
- To emphasize the importance of risk factor management in hypertensive individuals.
Main Methods:
- Prospective cohort study of 686 treated hypertensive men followed for 10 years.
- Data collected from standard clinical routine examinations at a hypertension clinic.
- Univariate and multivariate analyses performed on entry characteristics to determine independent predictors.
Main Results:
- The 10-year incidence of any CVD event was 15.3%, and of coronary heart disease (CHD) morbidity was 12.3%.
- Independent predictors of CVD morbidity included diastolic blood pressure (DBP), smoking, cholesterol, proteinuria, angina pectoris, and previous stroke.
- Similar variables, excluding previous stroke, predicted CHD morbidity.
Conclusions:
- Despite hypertension treatment, significant CVD risk persists in men with organ damage or other risk factors.
- Diastolic blood pressure, smoking, cholesterol, proteinuria, angina, and prior stroke are key predictors of CVD and CHD.
- Multifactorial risk factor intervention is critical for improving outcomes in hypertensive patients.
Abstract:
Prognostic factors for cardiovascular disease (CVD) were studied in 686 treated, middle-aged male hypertensives followed for 10 years at a hypertension clinic. The factors studied were all obtained from a standard clinical routine examination and both univariate and multivariate analyses were performed. Only entry characteristics were analysed. The 10-year incidence of any CVD event (CVD death, non-fatal myocardial infarction or non-fatal stroke) was 15.3% and of coronary heart disease (CHD) morbidity (fatal or non-fatal myocardial infarction) 12.3%. Independent predictors of CVD morbidity were diastolic blood pressure (DBP), smoking, cholesterol, proteinuria, angina pectoris and previous stroke. Except for a previous stroke the same variables were independent predictors of CHD. The findings show that in spite of treatment for hypertension, the CVD risk is still substantial if organ damage or other risk factors are present. The results underline the importance of multiple risk factor intervention in hypertensive patients.