Prevalence of hypertension and uncontrolled hypertension after solid organ transplantation: a 5-year follow-up of the Swiss Transplant Cohort Study.

Abstract

Objective: Hypertension (HTN) increases cardiovascular risk and is a frequent finding across all solid organ transplant recipients. We describe the prevalence of HTN and uncontrolled HTN, as well as details on pharmacologic treatment of HTN across solid organs transplant recipients up to five years after transplantation.

Methods: This retrospective study is nested in the prospective Swiss Transplant Cohort Study ( www.stcs.ch ) that includes kidney, heart, lung, and liver transplantation. Data extraction from 2008 to 2019 was used for this study and follow-up data at 6, 12 and 60 months was analyzed.

Results: A total of 3865 transplant recipients were included for analysis. The prevalence of HTN at 6 and 60 months was 88.9% and 90.4% in kidney ( P  = 0.21), 61.8% and 76.1% in liver ( P  < 0.01), 72.6% and 84.9% in lung ( P  < 0.01), and 89.3% and 85.8% in heart ( P  = 0.33) transplant recipients, respectively. The prevalence of uncontrolled HTN at 6 and 60 months was 40.3% and 38.9% in kidney ( P  = 0.48), 21.2% and 30.5% in liver ( P  = 0.05), 26.0% and 36.8% in lung ( P  = 0.03) and 38.9% and 18.5% in heart ( P  < 0.01) transplant recipients, respectively. At 12 months, compared to heart transplant recipients, kidney [odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.1-2.1], liver (OR = 1.7, 95% CI 1.1-2.6) and lung (OR = 2.6, 95% CI 1.6-4.0) transplant recipients had a higher likelihood of presenting with uncontrolled HTN.

Conclusion: HTN prevalence after solid organ transplantation is high. Uncontrolled and untreated HTN remain a major issue post transplantation, particularly in organ recipients not necessarily suffering from cardiovascular diseases such as liver or lung transplant recipients.