Early assessment of hypertension mediated organ damage is capable of predicting cardiovascular events in five years follow-up of patients with hypertension at a center in mendoza

Nicolas Federico Renna, Bryan Williams,Beder Farez, Martin Repetto, Pablo Bernasconi,Mario Murua, Jesica Ramirez,Roberto Miatello

JOURNAL OF HYPERTENSION(2021)

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摘要
Objective: Hypertension-mediated organ damage (HMOD) is a powerful predictor of mortality in hypertensive patients. The objective of the work was to determine the prognostic value of the early detection of HMOD in patients with a recent diagnosis of hypertension. Design and method: It is an analytical observational and prospective study that included all patients referred to Hypertension Unit of Hospital Español de Mendoza from January 2015 to December 2019 who met the following criteria: 1- Patients diagnosed with hypertension last 5 years; 2- Has been done a ABPM, 3- That has been done a Colour Doppler Echocardiography (CDE) with preserved ejection fraction and 4- a record of clinical history in the hospital that allowed obtaining the data and personal history. Exclusion criteria: 1- Patients who presented atrial fibrillation at the time of the Doppler echocardiogram study; 2- Any studies had missing or erroneous data, 3- Vital state could not be verified at the end of study, 4-Presence of any valve disease and 5- Ejection fraction of less than 40%, 5- Minor patients 16 years old. Variables and Measurements: ABPM; Colour Doppler Echocardiography (CDE) and patient data features; Results: Of the total of patients, 51% were women and 7,8% patients were diagnosed with diabetes mellitus. 196 endpoints were recorded during 60 months of evaluation. Men and patients with diabetes mellitus had a significantly greater number of events using the K-M (Hazard ratio 1.55 CI = 1.17 to 2.0 and Hazard ratio 1.77 CI = 1.04 to 3.0). In CDE, E/A ratio of the transmission flow (HR 1.43 HR CI 1.13–1.81).. The nocturnal PP showed a clear association with the occurrence of events (HR 190 HR CI 17.9 to 2022). Evaluation of morning pressure alone did not show associations with cardiovascular risk. Conclusions: The most important finding of the study was to find that a population with a diagnosis of arterial hypertension of less than 5 years, with low cardiovascular risk, the pressure of daytime, nighttime and morning surge was a predictor of hard cardiovascular events. So was the E / A ratio of left ventricular transmitral flow.
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