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

Gerardo Carpinella, Gennaro Pagano, Francesco Buono, Marta Petitto, Giovanna Guarino, Giuseppe Orefice, Giuseppe Rengo, Bruno Trimarco, Carmine Morisco

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Abstract

BACKGROUND Whether the combination of chronic kidney disease (CKD) and left ventricular hypertrophy (LVH) affects the cardiovascular (CV) risk in patients with uncomplicated hypertension is poorly investigated. The aim of this study was to assess the effects of LVH, CKD, and their combination on CV events in hypertension. METHODS This study analyzed 1,078 patients with essential hypertension. RESULTS LVH was present in 104 (9.6%) patients, CKD was present in 556 (51.5%) patients, and the combination of LVH and CKD was found in 174 (16.1%) patients. During the follow-up (median = 84 months), 52 CV events were observed (0.64 events/100 patient-years): 6 (2.4%) in patients without target-organ damage (TOD), 6 (5.7%) in patients with LVH, 20 (3.6%) in patients with CKD, and 20 (11.4%) in patients with combined LVH+CKD. Adjusted hazard ratio (HR) for CV events was 1.62 (P = 0.34) for LVH, 0.951 (P = 0.94) for CKD, and 2.45 (P = 0.03) for LVH+CKD. After multivariable Cox proportional hazard analysis, the combination of LVH+CKD was significantly associated with risk of CV events, when the model was adjusted for sex and age (HR = 2.447; P = 0.03) and for the presence of 1 CV risk factor (HR = 3.226; P = 0.02). In contrast, the association of LVH+CKD was no longer significant when the model was adjusted for sex, age, and the presence of ≥ 2 CV risk factors. CONCLUSIONS The results of this study highlight the relevance of the interactions between TODs and hemodynamic, anthropometric, and metabolic abnormalities in the CV risk stratification of patients with essential hypertension.

Original languageEnglish
Pages (from-to)127-134
Number of pages8
JournalAmerican Journal of Hypertension
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

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Keywords

  • Blood pressure
  • Cardiovascular risk
  • Chronic kidney disease
  • Essential hypertension
  • Hypertension
  • Left ventricular hypertrophy
  • Myocardial infarction
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

Cite this

Carpinella, G., Pagano, G., Buono, F., Petitto, M., Guarino, G., Orefice, G., Rengo, G., Trimarco, B., & Morisco, C. (2015). Prognostic value of combined target-organ damage in patients with essential hypertension. American Journal of Hypertension, 28(1), 127-134. https://doi.org/10.1093/ajh/hpu098