THE PARACLINICAL EVOLUTION OF OBESE HYPERTENSIVE PATIENTS

Abstract

Objective: to assess paraclinical evolution in obese patients with essential systemic hypertension Design and method: 150 patients older than 40 years, with SH (more than 7 years, diagnosed between 35 and 42 years age) and obesity (BMI>30 kg/m2) were included. It was a retrospective study. All the patients with systolic heart failure NYHA II-IV and coronary major events were excluded. In all patients were recorded retrospective data regarding clinical findings, blood tests (lipid profile, glycemia, uric acid, TSH, microalbuminuria), ECG, blood pressure monitoring (at least one in the last 2 years) and echocardiography (performed in the last year). The patients were divided into two groups: the study group (n = 72) with hyperuricemia – and the control group (n = 78): patients without hyperuricemia. In all patients were assessed LV function and rest heart rate. In both groups were included only patients with heart rate <90b/min, in sinus rhythm and with EF>55%. Results: The mean age was 48.9 years and 52.9% were men. The patients from the two groups had the same profile of risk factors and associated comorbidities (except hyperuricemia). The treatment and the level of blood pressure control were the same (average BP was 141.5/84.8 in study group and 141.6/84.9 in control group). The median duration of systemic hypertension was 8.4 years (between 7 and 12 yrs). The heart rate was slowly increased in the study group (76.4 vs 70.2). The echocardiography showed an increased end diastolic left ventricle diameter in study group (57.2 vs 56.7 mm) and left atrium diameter (41.5 vs 40.5 mm). In the study group were registered during SH evolution 9 new cases of diabetes mellitus type 2 and 11 patients with microalbuminuria. In the control group were registered during SH evolution 4 new cases of diabetes mellitus type 2 and 7 patients with microalbuminuria. Conclusions: Hyperuricemia could be considered an independent risk factor for patients with systemic hypertension. Its presence accelerates the deterioration of clinical parameters of these patients in spite of the control of hypertension and similar clinical profile. Further studies are needed to confirm.