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Hepatitis C Infection as a Risk Factor for Hypertension and Cardiovascular Diseases: An EpiTer Multicenter Study
Paweł Rajewski1, Dorota Zarębska-Michaluk2, Ewa Janczewska3
1Department of Internal and Infectious Diseases, Provincial Infectious Disease Hospital, 85-030 Bydgoszcz, Poland.
Insights
Hepatitis C infection is linked to higher rates of hypertension and cardiovascular disease, especially with advanced liver fibrosis. Further research is needed to understand this connection.
Area of Science:
- Hepatology
- Cardiology
- Infectious Diseases
Background:
- Hepatitis C infection is a primary cause of liver cirrhosis and hepatocellular carcinoma.
- Extrahepatic manifestations of Hepatitis C, including cardiovascular effects, are increasingly recognized.
- Hypertension and cardiovascular diseases are potential complications of Hepatitis C infection.
Purpose of the Study:
- To analyze the incidence of hypertension and cardiovascular diseases in Hepatitis C Virus (HCV)-infected patients in Poland.
- To assess the relationship between hypertension/cardiovascular diseases and HCV genotype and liver fibrosis progression.
- To investigate HCV as a non-classical risk factor for cardiovascular disease and hypertension.
Main Methods:
- Frequency analysis of hypertension and cardiovascular disease incidence.
- Study conducted on 2898 HCV-infected patients in Poland.
- Assessment of associations with patient age, sex, HCV genotype, and liver fibrosis stage (F1-F4).
Main Results:
- Hypertension prevalence was 39%, significantly associated with older age and advanced liver fibrosis (F3/F4).
- Cardiovascular disease incidence was 4.52%, including ischemic heart disease (3.95%) and atherosclerosis (0.72%).
- Cardiovascular disease prevalence strongly correlated with advanced age and liver fibrosis progression; no link to sex or HCV genotype was found.
Conclusions:
- Hepatitis C infection is associated with increased prevalence of hypertension and cardiovascular diseases.
- Advanced liver fibrosis and older age are key risk factors for these conditions in HCV patients.
- HCV genotype does not appear to influence the risk of hypertension or cardiovascular diseases.
Abstract:
Hepatitis C infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, more and more is being heard about extrahepatic manifestations of the hepatitis C infection including its possible influence on the development of hypertension and cardiovascular diseases. In the given work, the frequency analysis of the incidence of hypertension and cardiovascular diseases among 2898 HCV-infected patients treated in Poland and the assessment of their relevance to the HCV genotype and the progression of liver fibrosis can be found. The prevalence of hypertension in the group of analyzed patients was 39% and was significantly associated with old age (OR = 1.08 (1.07-1.08)) and female sex, as well as the progression of liver fibrosis (OR = 1.54 (1.29-1.85)). Hypertension was found in 47.6% of patients with F4 fibrosis, 42.1% of patients with F3 fibrosis, and 25% of patients with F1 fibrosis. The incidence of cardiovascular disease in the studied group of patients was as follows: all incidents, 131 (4.52%); including ischemic heart disease 104, (3.95%); stroke, 2 (0.07%); atherosclerosis, 21 (0.72%); and aneurysms, 4 (0.14%). The obtained results prove that the prevalence of cardiovascular diseases is significantly associated with the advanced age of patients and the progression of liver fibrosis. The relevance of sex and the HCV genotype to the prevalence frequency of cardiovascular diseases in the study group has not been proven. This being the case, no differences in the frequency of their incidence depending on the HCV genotype, including genotype 3, was found. Hepatitis C infection as a non-classical risk factor for cardiovascular disease and hypertension does require further studying.
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