Factors, associated with major adverse events in rural males with arterial hypertension at long-term follow-up

Abstract

Background and Aims : To study the factors, associated with major adverse events (MAEs) in rural males with uncomplicated arterial hypertension (HTN) at long-term follow-up.Methods: The prospective study enrolled 160 rural males with uncomplicated primary HTN (mean age 50 ± 6 years). We analyzed clinical and instrumental data. High-to-very high SCORE cardiovascular risk was identified in 102 (63,7%) patients. Blood pressure visit-to-visit variability (VVV) was assessed by standard deviation and coefficient of variation (CV) (derived from the four consecutive visits). Left ventricular (LV) hypertrophy (by echo) was detected in 129 (80,6%) patients. The median of follow-up was 27 months (interquartile range 24-30 months). During the follow-up period, 14 (8,8%) patients presented with MAEs (totally, 17 events): acute cerebrovascular event (n=9); myocardial infarction (n=2); first-onset atrial fibrillation (AF) (n=2); AF transition in permanent pattern (n=2); and relative LV ejection fraction decline >10% (n=2).Results: At multivariable analysis, the factors, associated with MAEs at long-term follow-up, were as follows: SCORE cardiovascular risk (per 1 % increase: HR 1,09 (95% CI 1,01-1,17); р=0,034); mean arterial pressure (MAP) (per 1 mm Hg increase: HR 1,23 (95% CI 1,07-1,41); р=0,003); CV (MAP) (per 1% increase: HR 1,41 (95% CI 1,08-1,83); р=0,012); and LV myocardial mass, indexed by height2,7 (per 1 g/m2,7 increase: HR 1,07 (95% CI 1,03-1,11); р=0,001).Conclusions: Long-term MAEs in rural HTN males were associated with SCORE cardiovascular risk, MAP, MAP VVV (by CV) and LV myocardial mass index (by height2,7). These factors should be taken into account while MAEs risk stratification in rural males with uncomplicated HTN. Background and Aims : To study the factors, associated with major adverse events (MAEs) in rural males with uncomplicated arterial hypertension (HTN) at long-term follow-up. Methods: The prospective study enrolled 160 rural males with uncomplicated primary HTN (mean age 50 ± 6 years). We analyzed clinical and instrumental data. High-to-very high SCORE cardiovascular risk was identified in 102 (63,7%) patients. Blood pressure visit-to-visit variability (VVV) was assessed by standard deviation and coefficient of variation (CV) (derived from the four consecutive visits). Left ventricular (LV) hypertrophy (by echo) was detected in 129 (80,6%) patients. The median of follow-up was 27 months (interquartile range 24-30 months). During the follow-up period, 14 (8,8%) patients presented with MAEs (totally, 17 events): acute cerebrovascular event (n=9); myocardial infarction (n=2); first-onset atrial fibrillation (AF) (n=2); AF transition in permanent pattern (n=2); and relative LV ejection fraction decline >10% (n=2). Results: At multivariable analysis, the factors, associated with MAEs at long-term follow-up, were as follows: SCORE cardiovascular risk (per 1 % increase: HR 1,09 (95% CI 1,01-1,17); р=0,034); mean arterial pressure (MAP) (per 1 mm Hg increase: HR 1,23 (95% CI 1,07-1,41); р=0,003); CV (MAP) (per 1% increase: HR 1,41 (95% CI 1,08-1,83); р=0,012); and LV myocardial mass, indexed by height2,7 (per 1 g/m2,7 increase: HR 1,07 (95% CI 1,03-1,11); р=0,001). Conclusions: Long-term MAEs in rural HTN males were associated with SCORE cardiovascular risk, MAP, MAP VVV (by CV) and LV myocardial mass index (by height2,7). These factors should be taken into account while MAEs risk stratification in rural males with uncomplicated HTN.