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The hypertension-based chronic disease model in a primary care setting

Eduardo Thadeu de Oliveira Correia1,2, Jeffrey I Mechanick3, Antonio José Lagoeiro Jorge2

  • 1Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

International Journal of Cardiology. Cardiovascular Risk and Prevention
|September 4, 2023
PubMed

Insights

The novel Hypertension-Based Chronic Disease (HBCD) model effectively categorizes cardiometabolic risk. Higher HBCD stages correlate with poorer health outcomes, including increased mortality and cardiovascular events.

Area of Science:

  • Cardiology
  • Nephrology
  • Public Health

Background:

  • Cardiometabolic risk is a significant public health challenge.
  • Existing driver-based chronic disease models lack data on the novel Hypertension-Based Chronic Disease (HBCD) model.
  • This study addresses the need for data on HBCD model prevalence, characteristics, and prognostic significance.

Purpose of the Study:

  • To investigate the prevalence and characteristics of the Hypertension-Based Chronic Disease (HBCD) model.
  • To assess the prognostic significance of HBCD Stages in a primary care cohort.
  • To validate the HBCD model as a tool for understanding cardiometabolic risk progression.

Main Methods:

  • A cohort of 633 primary care participants (aged ≥45) in Brazil was randomly selected.
  • Participants underwent electrocardiogram and tissue Doppler echocardiogram.
  • Participants were classified into HBCD Stages (1-4) and followed for a median of 6 years for prognostic analysis.

Main Results:

  • Prevalence: 1.3% no risk factors, 10.0% Stage 1, 14.7% Stage 2, 51.5% Stage 3, 22.5% Stage 4.
  • Worsening HBCD stages correlated with poorer kidney function, adverse echocardiographic markers, higher BMI, and increased type 2 diabetes prevalence.
  • All-cause mortality or cardiovascular hospitalization rates increased significantly across HBCD Stages (Stage 1: 3.6% to Stage 4: 39.5%).

Conclusions:

  • The Hypertension-Based Chronic Disease (HBCD) model is conceptually and prognostically valid.
  • HBCD stages are significantly associated with worsening cardiac and kidney health markers.
  • The HBCD model predicts increased risk of mortality and cardiovascular hospitalization.
Abstract

Keywords:
Blood pressureCardiometabolic diseaseHypertensionPrehypertension

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