Abstract
Purpose. NT proBNP is routinely used in the diagnosis and prognosis of HF. The study aimed to determine whether the value of NT proBNP can be used in hypertensive patients to detect patients at risk of developing HF and whether in these patients medical management guided by NT proBNP can prevent the development of HF. Material and methods. We included 275 hypertensive patients who presented to the Bagdasar-Arseni Emergency Hospital for cardiological consultation for a period of 3 years. Patients diagnosed with heart failure or left ventricular systolic dysfunction and patients with symptoms of heart failure at enrollment were excluded. We divided the patients into 2 groups, a control group and an intervention group. Patients in the intervention group were managed according to the NT proBNP value, and patients in the control group received standard treatment. Results. The objectives pursued at 3 years were: diagnosis of heart failure, systolic or diastolic dysfunction of the left ventricle and hospitalization for cardiovascular pathology. After 3 years, in the control group there were 34 patients (25.4%) who developed HF, compared to 24 patients (17.0%) in the intervention group. In the control group, 51 patients (38.1%) were diagnosed with LV systolic dysfunction compared to 37 patients (26.2%) in the intervention group. Regarding diastolic LV dysfunction, in the control group there were 83 patients (61.9%), and in the intervention group there were 73 patients (51.8%). Also, the rate of hospitalizations for cardiovascular pathology was higher in the control group 47 patients (35.1%) compared to 27 patients (19.1%) in the intervention group. Discussions. Hypertensive patients in the intervention group, who were managed according to the NT proBNP value, had a lower incidence rate of heart failure, LV systolic or diastolic dysfunction, or hospitalizations for cardiovascular events than in the control group. Conclusions. The value of NT proBNP may be useful for detecting hypertensive patients at risk of developing HF, and NT proBNP-guided medical management may prevent or delay the onset of HF.
Highlights
NT proBNP is routinely used in the diagnosis and prognosis of HF
Riscul de apariţie a disfuncţiei sistolice de ventriculului stâng (VS) la 3 ani la pacienţii hipertensivi a fost semnificativ statistic (p = 0,036), mai mic în grupul de intervenţie comparativ cu grupul de control (RR = 0,756; 95% CI = 0,573-0,997) (Figura 2)
Riscul de apariţie a disfuncţiei diastolice de VS la 3 ani la pacienţii hipertensivi a fost nesemnificativ statistic (p = 0,089), mai mic în grupul de intervenţie comparativ cu grupul de control (RR = 0,819; 95% CI = 0,652-1,029) (Figura 3)
Summary
NT proBNP is routinely used in the diagnosis and prognosis of HF. The study aimed to determine whether the value of NT proBNP can be used in hypertensive patients to detect patients at risk of developing HF and whether in these patients medical management guided by NT proBNP can prevent the development of HF. Pacienţii hipertensivi din grupul de intervenţie, care au fost manageriaţi în funcţie de valoarea NT proBNP, au avut o rată mai scăzută de incidenţă a insuficienţei cardiace, a disfuncţiei sistolice sau diastolice de VS sau a spitalizărilor pentru evenimentele cardiovasculare faţă de pacienţii din grupul de control.
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