MO725: The Risk of Hypertension and Atrial Fibrillation in Hemodialysis Patients

Abstract

Abstract BACKGROUND AND AIMS This study aims to evaluate the prevalence of and the association between hypertension (HTN) in and AF in hemodialysis patients. METHOD All patients receiving hemodialysis for at least 6 months were included in the study. Demographic, hemodynamic and laboratory data were retrieved from the BestCare system, and the main outcomes were the pre/post-dialysis blood pressure measurements and the presence of AF. The data were analyzed using the SPSS program. For determination of independent effect of laboratory variables, multiple logistic regression was used to evaluate the independent effect of the laboratory. RESULTS Our sample consisted of 304 HD patients; 162 (53%) were male and the mean age was 63 ± 18 years. One-fifth, 68 (20%) had AF of whom, 44 (64.7%) were male with mean age of 73 ± 12 years. The mean age in the AF group was significantly higher in males 73(12) versus 61 (18) years (p = 0.001) The risk of AF increased by 0.4 [odd ratio 1.04, 95% confidence interval (95% CI) 1.02–1.06; P < 0.001] for every year of age and there were more males than fem ales (64.7% versus 35.3%; P = 0.032). Almost two-thirds the entire sample (66.45%, n = 202) were hypertensive, with mean age of 64 ± 17 years and almost a third had a BMI in the obese category (28.7%, n = 58). Male patients were 33% less likely to develop hypertension (odd ratio 0.77, 95% CI 0.47–1.24; P = 0.289). Based on logistic regression analysis, the patients who had both HTN and diabetes were more likely to develop AF (odd ratio 7.12, 95% CI 0.91–55.1; P = 0.060), compared with patients who did not. According to the logistic regression analysis, male patients were 33% less likely to develop hypertension (odd ratio 0.77, 95% CI 0.47–1.24; P = 0.289), and age had no effect OR = 1. In addition, with every increase of the Carlson comorbidity index score by two points, there was a 40% increased risk of developing HTN (odd ratio 2.47, 95% CI 1.17–5.18; P = 0.017). According to the univariate analysis, having HTN before dialysis increased the risk of continuing anti-hypertensive therapy by 23% (odd ratio 1.37, 95% CI 0.81–2.36; P = 0.756). However, after adjusting the analysis for other cofactors, the odd ratio became less significant, suggesting that the risk increased only by 0.9% (odd ratio 1.09, 95% CI 0.60–1.99; P = 0.756). Being a male was associated with a 54% (odd ratio 0.54, 95% CI 0.31–0.95; P = 0.019) decrease in the risk of developing HTN on hemodialysis. Almost two-thirds (66.1%, n = 197) were hospitalized during the previous 12 months, the majority were due to dialysis-related infections. The mortality rate was 5.9% (Table 1). CONCLUSION The risk factors for the development of HTN and AF in HD patients were found to be increasing age for AF and female gender for hypertension. The presence of HT and DM increases the risk of developing AF 7-fold after hemodialysis.