Factores de riesgo en los pacientes con hipertensión arterial sin eventos cardiovasculares previos

Abstract

Background and objective Guidelines recommend management of patients based not only on the degree of blood pressure elevation, but in total cardiovascular risk. The aim of the present study was to evaluate the distribution of cardiovascular risk categories in hypertensive patients without evidence of previous cardiovascular events, as well as the relative contribution of each factor responsible for this distribution. Patients and methods Cross-sectional, observational, and multicentre study in a cohort of 6,762 treated hypertensive patients, without evidence of previous cardiovascular events. Data responsible for cardiovascular risk stratification (additional cardiovascular risk factors and target organ damage) were collected. The presence of such factors, as well as changes in risk stratification due to individual removal were evaluated. Results Most patients fulfilled criteria of high or very-high cardiovascular risk. Most frequently present factors were lipid alterations (73.6%) followed by advanced age (sex-adjusted) in 50.8% and abdominal obesity (31.7%). Regarding target organ damage, abnormalities in renal function (24.1%), left ventricular hypertrophy (16.4%) and microalbuminuria (10.7%) were the most frequently observed. A 29% of patients would reduce their cardiovascular risk categorization if lipid abnormalities were absent. In comparison, when other risk factors were removed from risk categorization, it affected less than 10% of patients. Conclusion Most of the hypertensive subjects fall in high or very-high cardiovascular risk categories. Lipid abnormalities are the most frequent risk modificator and has the most important quantitative impact in risk categorization.