FACTORS ASSOCIATED WITH AN INCREASED RISK OF ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: To identify factors associated with an increased risk of adverse cardiovascular events in patients with arterial hypertension Design and method: We analyzed the results of 455 patient case files of patients with arterial hypertension included in the database in the period from January 2016 to May 2020. We made a phone call to all patients to identify new cases of adverse cardiovascular events (ischemic heart disease, stroke, transient ischemic attack, atrial fibrillation, chronic heart failure, death). 371 (81.5%) of 455 patients answered. Results: 45 adverse cardiovascular events occurred in 371 patients with arterial hypertension. Such factors as the age of the onset of hypertension, the duration of hypertension, gender, obesity, dyslipidemia, hyperuricemia, left ventricular hypertrophy, and severe retinopathy were analyzed to assess the relationship with adverse cardiovascular events. According to the Kaplan-Meier survival analysis in the presence of severe retinopathy, the risk of complications after 36 months of follow-up was 50% (p = 0.018). The hazard ratio for complications in the presence of severe retinopathy was 7.88 (CI 1.05–58.98; p = 0.044). Besides only 8 (1.75%) of 455 studied patients with arterial hypertension had severe retinopathy (retinal hemorrhage, microaneurysm, cotton wool spot, hard exudates or optic disc swelling). All 8 patients had a resistant arterial hypertension. No other evidence of interaction was found between other factors and the risk of adverse cardiovascular events. Conclusions: Severe retinopathy is more common in patients with resistant hypertension. Severe retinopathy is associated with an increased risk of adverse cardiovascular events in patients with arterial hypertension