PP.14.13] CARDIOVASCULAR AND NONCARDIAC COMORBIDITY IN PATIENTS WITH COMBINATION OF ARTERIAL HYPERTENSION, CHRONIC HEART FAILURE AND ATRIAL FIBRILLATION

Abstract

Objective: Purpose of the study was to evaluate cardiovascular diseases (CVD) and noncardiac comorbidity in patients with combination of arterial hypertension (AH), chronic heart failure (CHF), atrial fibrillation (AF) on the basis of the hospital registry of CVD. Design and method: The total of 3380 patients with AH hospitalized to the National Research Center for Preventive Medicine (Moscow, Russia) from April 2013 to December 2014 were enrolled in the registry RECVASA-CLINICA. Data of the hospital information system MEDIALOG were analyzed. The combination of AH, CHF, AF was revealed in 563 (16.7%) hypertensives, including 291 (51.7%) patients with ischemic heart disease (IHD), CVD4 group and 272 (48.3%) patients without IHD, CVD3 group. Hypertensives without other CVD or with only CHF/AF were classified into group CVD1-2 (n = 1494). Results: Incidence of stroke in anamnesis was higher in CVD3 and CVD4 groups (20.2% and 21.6%) compared with CVD1-2 (12.4%), p = 0.0006 and 0.0001. Patients of CVD3 and CVD4 groups had a larger number of non comorbid of CVD (2.1 ± 1.1 and 2.4 ± 1.2) than in CVD1-2 (1.7 ± 1.1), p < 0.001, including higher incidence of pulmonary diseases (25.7% and 34.4% vs 17.2%, p = 0.0009 and 0.0001), diabetes (24.3% and 28.9% vs 13.9%, p = 0.0001 and 0.0001), obesity (44.1% and 36.7% vs 28.6%, p = 0.0001 and 0.001), anemia (5.9% and 8.5% vs 2.9%, p = 0.01 and 0.0001). Patients of group CVD4 compared with group CVD1-2 had bigger incidence of renal diseases and digestive system diseases (48.5% and 82.1% vs 34.3% and 69.9%, p = 0.0001 and 0.0001). In group CVD4 incidence of pulmonary and digestive system diseases (34.4% and 82.1%) was higher than in CVD3 (25.7% and 73.2%), p = 0.03 and p = 0.02. Conclusions: The RECVASA–CLINICA study revealed the combination of AH, CHF, AF in 16.7% of hypertensives and approximately half of them (8.6%) also had IHD. Incidence of stroke was significantly bigher in patients with AH, CHF, AF and AH, CHF, AF, IHD combinations than in hypertensives without other CVD or with only CHF/AF. Cardiovascular comorbidity was associated with noncardiac comorbidity that was significantly more pronounced in patients with AH, CHF, AF and AH, CHF, AF, IHD combinations.