Prolonged Time-to-antihypertensive Therapy Worsens Organ Damage and Blood Pressure Control in Arterial Hypertension.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE
Maria Lembo, Maria Virginia Manzi, Daniela Pacella, Raffaele Piccolo, Maria Angela Losi, Grazia Canciello, Costantino Mancusi, Luca Bardi, Giuseppe Giugliano, Carmine Morisco, Bruno Trimarco, Daniela Carnevale, Raffaele Izzo, Eduardo Bossone, Giovanni Esposito
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引用次数: 0

Abstract

Introduction: Delay in arterial hypertension (AH) diagnosis and late therapy initiation may affect progression towards hypertensive-mediated organ damage (HMOD) and blood pressure (BP) control.

Aim: We aimed to assess the impact of time-to-therapy on BP control and HMOD in patients receiving AH diagnosis.

Methods: We analysed data from the Campania Salute Network, a prospective registry of hypertensive patients (NCT02211365). At baseline visit, time-to-therapy was defined as the interval between the first occurrence of BP values exceeding guidelines-directed thresholds and therapy initiation; HMOD included left ventricular hypertrophy (LVH), carotid plaque, or chronic kidney disease. Optimal BP control was considered for average values < 140/90 mmHg. Low-risk profile was defined as grade I AH without additional cardiovascular risk factors.

Results: From 14,161 hypertensive patients, we selected 1,627 participants who were not on antihypertensive therapy. This population was divided into two groups based on the median time-to-therapy (≤ 2 years n = 1,009, > 2 years n = 618). Patients with a time-to-therapy > 2 years had higher risk of HMOD (adjusted odds ratio, aOR:1.51, 95%, CI:1.19-1.93, p < 0.001) due to increased risks of LVH (aOR:1.43, CI:1.12-1.82, p = 0.004), carotid plaques (aOR:1.29, CI:1.00-1.65, p = 0.047), and chronic kidney disease (aOR:1.68, CI:1.08-2.62, p = 0.022). Time-to-therapy > 2 years was significantly associated with uncontrolled BP values (aOR:1.49, CI:1.18-1.88, p < 0.001) and higher number of antihypertensive drugs (aOR:1.68, CI:1.36-2.08, p < 0.001) during follow-up. In low-risk subgroup, time-to-therapy > 2 years did not impact on BP control and number of drugs.

Conclusions: In hypertensive patients, a time-to-therapy > 2 years is associated with HMOD and uncontrolled BP.

延长降压治疗时间会加重动脉高血压的器官损伤和血压控制。
导言:目的:我们旨在评估接受动脉高血压诊断的患者中,治疗时间对血压控制和动脉高血压所致器官损伤的影响:我们分析了坎帕尼亚健康网络(Campania Salute Network)的数据,这是一项前瞻性的高血压患者登记项目(NCT02211365)。在基线就诊时,治疗时间被定义为血压值首次超过指南指导阈值与开始治疗之间的时间间隔;HMOD包括左心室肥厚(LVH)、颈动脉斑块或慢性肾病。结果:我们从 14,161 名高血压患者中选出了 1,627 名未接受降压治疗的患者。根据治疗时间的中位数(≤ 2 年 n = 1,009 人,> 2 年 n = 618 人)将这些患者分为两组。治疗时间大于 2 年的患者罹患 HMOD 的风险更高(调整赔率 aOR:1.51,95%,CI:1.19-1.93,p):结论:在高血压患者中,治疗时间大于 2 年与 HMOD 和血压失控有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.70
自引率
3.30%
发文量
57
期刊介绍: High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes:   Invited ''State of the Art'' reviews.  Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
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