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Prolonged Time-to-antihypertensive Therapy Worsens Organ Damage and Blood Pressure Control in Arterial Hypertension

Maria Lembo1, Maria Virginia Manzi1, Daniela Pacella2

  • 1Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.

High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension
|October 5, 2024
PubMed

Insights

Delaying arterial hypertension therapy initiation beyond two years increases the risk of hypertensive-mediated organ damage and uncontrolled blood pressure. Early treatment is crucial for better patient outcomes.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Trials

Background:

  • Delayed diagnosis and treatment of arterial hypertension (AH) can accelerate hypertensive-mediated organ damage (HMOD) and impede blood pressure (BP) control.
  • Understanding the impact of treatment initiation timing is critical for managing AH effectively.

Purpose of the Study:

  • To evaluate how the time to initiating antihypertensive therapy affects BP control and the development of HMOD in diagnosed AH patients.
  • To identify specific HMOD risks associated with delayed treatment.

Main Methods:

  • Analysis of data from the Campania Salute Network, a prospective registry of hypertensive patients (NCT02211365).
  • Time-to-therapy defined as the interval between elevated BP and treatment initiation.
  • HMOD assessment included left ventricular hypertrophy (LVH), carotid plaque, and chronic kidney disease.
  • Optimal BP control defined as <140/90 mmHg.

Main Results:

  • A cohort of 1,627 untreated hypertensive patients was analyzed, with a median time-to-therapy of 2 years.
  • Patients with time-to-therapy >2 years showed significantly higher risks of HMOD (aOR: 1.51), including LVH, carotid plaques, and chronic kidney disease.
  • Delayed therapy (>2 years) was strongly linked to uncontrolled BP (aOR: 1.49) and a greater need for antihypertensive medications (aOR: 1.68).

Conclusions:

  • In patients with arterial hypertension, delaying therapy initiation for over two years is significantly associated with increased risks of HMOD and poor BP control.
  • These findings underscore the importance of timely antihypertensive treatment to prevent organ damage and achieve therapeutic goals.
Abstract

Keywords:
Arterial hypertensionBlood pressure controlHypertensive-mediated organ damage

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