PP.01.19] PREDICTORS OF CARDIOVASCULAR EVENTS IN HYPERTENSIVE PATIENTS WITH HIGH CARDIOVASCULAR RISK

Abstract

Objective: Hypertension is a major risk factor for cardiovascular events. Patients at high risk are particularly vulnerable and require adequate treatment and control. The treatment is complex and requires good control of blood pressure and all modifiable risk factors associated with the protection of target organ damage. The goal of this study is to determine which factors have predictive significance of cardiovascular events in patients with hypertension and high cardiovascular risk. Design and method: We studied 258 participants (60% females). Each participant underwent asymptomatic organ damage: 12-lead electrocardiogram examinations, two-dimensional and Doppler echocardiographs, Doppler sonography of the carotid arteries, and laboratory investigations were prospectively followed for fatal and non-fatal cardiovascular event and total mortality over a median of 7 years. Results: Mean age in the beginning of the study was 62.7 ± 9 years, body mass index of 28.9 ± 4. kg/m2, office blood pressure of 150.3 ± 20/87.6 ± 13 mmHg, left ventricular mass index (LVMI) of 129.8 ± 29 g/m2, carotid intima -media thickness (IMT) of 0.92 ± 0.2 mm. Diabetes mellitus (DM) was in 28% patients, mean total cholesterol 5.74 ± 1 mmol/l. At a follow-up, the incidence of non-fatal and fatal cardiovascular events was 18.2%, and total mortality was 4.7%. Major cardiovascular events were more common in men (p = 0.019) and were highly correlated with systolic blood pressure (SBP) at the beginning of the study (p = 0.038), with cholesterol at the beginning of the study(p = 0.019) and at the end of the study (p = 0.028), glucoses at the beginning of the study(p = 0.004), DM at the beginning (p = 0.001) and at the end (p = 0.006), LVMI (p < 0.001) and IMT (p < 0.001) at the beginning. Patients with a cardiovascular death were significantly older (p = 0.002), had higher SBP at the beginning (p = 0.017) and higher IMT (p = 0.017). During the study 7.4% of participants got cancer and its positive correlation with DM was determined at the end of the study (p = 0.002) and with IMT at the end of the study (p = 0.037). Conclusions: Main predictors of major cardiovascular events among patients with hypertension and high risk are: age, male sex, SBP, DM and IMT.