Electrocardiographic strain pattern and the prediction of cardiovascular morbidity and mortality in hypertensive patients: The LIFE study

Background : Whether aortic regurgitation (AI) is associated with higher cardiovascular (CV) morbidity and mortality in hypertension with electrocardiographic (ECG) left ventricular hypertrophy (LVH) is unknown. Methods : Hypertensive patients with ECG-LVH were randomized to losartan- or atenolol-based treatment and followed for 4.8 years in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. In the LIFE echo substudy, echocardiograms were used to detect AI. Baseline clinical, echocardiographic variables and cardiovascular endpoints data were used in current analyses. Results: The presence of AI was detected in 132 participants (68 women; 68.4 ± 7.3 years). AI was associated with older age (p < 0.001) but not gender. After adjustment for age, AI was associated with significantly increased LV mass indexed by body surface area (BSA) and height 2.7 (both p < 0.005), echocardiographic eccentric LVH (p < 0.05) but not concentric left ventricular (LV) geometry (p < 0.05). After adjusting for significant confounders including history of CV disease, Framingham risk score, randomized antihypertensive therapy, LV eccentric geometry, LV mass indexed by BSA and height 2.7 , multivariate Cox regression analyses showed that AI was independently associated with 2.83-fold more CV death (95% confidence interval [CI] 1.12 to 7.13), 2.24-fold more all-cause mortality (95% CI 1.17 to 4.28) (both p < 0.05). Conclusion : In hypertensive patients with ECG-LVH, AI independently identifies patients at increased risk of CV and all-course mortality.

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STUDY OF MICROALBUMINURIA IN PATIENTS WITH NORMOGLYCEMIC HYPERTENSION

10.36106/ijsr/4505067 ◽

2021 ◽

pp. 68-70

Author(s):

Ketan Prajapati ◽

Sanket Makwana ◽

M. J. Sonagara

Keyword(s):

Body Mass Index ◽

Essential Hypertension ◽

Body Mass ◽

Independent Predictor ◽

Blood Pressure Measurement ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Hypertensive Patients ◽

Arterial Blood ◽

Cardiovascular Morbidity And Mortality

INTRODUCTION:Hypertension is one of the most important risk factors for cardiovascular disease. The incidence of microalbuminuria is more common among hypertensive patients, even in nondiabetic patients. Microalbuminuria is an independent predictor of cardiovascular morbidity and mortality in patients with essential hypertension. Therefore, current guidelines recommend routine screening of microalbuminuria in hypertensive patients to ensure appropriate interventions are initiated early in the disease process before progression to chronic kidney disease and/or renal failure. AIMS & OBJECTIVES:This study is done to estimate the prevalence of microalbuminuria in patients with normoglycemic hypertension and to identify other variables associated with it. MATERIAL & METHODS:In this study, we randomly selected 100 patients with essential hypertension based on inclusion and exclusion criteria. CBC, renal function test, 24-hour urine albumin excretion (UAE), Body mass index (BMI), and arterial blood pressure measurement were done among all selected patients. Data entry was done in Microsoft Ofce Excel and analysis was done using the software package Epi Info (Version 7.1.5) from CDC, Atlanta, U.S.A. OBSERVATIONS & RESULTS: The study was conducted among 100 hypertensive patients out of which 74 were male and 24 were female. Out of 100 patients, microalbuminuria was present in 44 patients. Mean arterial pressure was found high among patients with microalbuminuria than patients without microalbuminuria. The presence of microalbumin in urine was found to increase with the increasing severity of hypertension. Mean body mass index and serum creatinine were found higher in the microalbuminuric group than the normoalbuminuric group. CONCLUSION:The incidence of microalbuminuria is more common among hypertensive patients, even in nondiabetic patients. The presence of microalbuminuria is an independent predictor of cardiovascular morbidity and mortality in patients with essential hypertension. Screening for microalbuminuria is a relatively simple process, should facilitate early vascular disease detection.

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