In:
Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 60, No. suppl_1 ( 2012-09)
Abstract:
Renal function and albuminuria predict CV disease in general population, but their predictive value in resistant hypertension (RH) is rather unknown. Aim: to determine the ability of renal parameters to predict adverse CV outcomes in RH patients. Methods: One hundred thirty-three (59% males, aged 61yr) RH pts. (BP ≥140/90 mmHg despite treated with ≥3 antihypertensive drugs) were evaluated. Mean follow-up: 88±5 months. Primary composite end-point: first occurrence of a CV event (nonfatal myocardial infarction, nonfatal stroke, new-onset heart failure, coronary or peripheral by-pass) or CV death. Renal function was assessed by serum creatinine, creatinine clearance (CrCL) and urine albumin/creatinine ratio (UACR). Microalbuminuria (MAB) was defined as UACR 〉 30mg/g. Results: Twenty-two subjects (16.5%) reached the primary end-point. After adjustments for previous CV disease, systolic BP both at baseline and during follow-up and CrCl, high UACR during follow-up was significantly associated with a worse CV outcome (Table). More patients who had a CV event developed MAB at follow-up (28% vs. 6%), whereas the proportion with MAB regression in this group was lower (11% vs. 19%); p=0.005. Although renal function was also associated with outcome in unadjusted analyses, the significance was lost after baseline risk and BP adjustment. Conclusion: in patients with resistant hypertension, microalbuminuria at follow-up but not at baseline independently predicts CV outcomes. * adjusted for SBP both at baseline and during follow-up and previous CV disease ** adjusted for the aforementioned confounders plus CrCl both at baseline and at follow-up; UACR tested after log transformation.
Type of Medium:
Online Resource
ISSN:
0194-911X
,
1524-4563
DOI:
10.1161/hyp.60.suppl_1.A320
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2012
detail.hit.zdb_id:
2094210-2
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