Prediction of cardiovascular events in older patients with hypertension in primary care : a cohort study
© The Authors..
BACKGROUND: Accurate risk stratification identifying patients with hypertension at risk of future cardiovascular disease in primary care would be desirable.
AIM: To investigate the association between elevated brain natriuretic peptide (BNP), left ventricular hypertrophy (LVH) on an electrocardiogram (ECG), and LVH on an echocardiogram and the development of cardiovascular events (CVEs), especially heart failure and all-cause mortality (ACM), in a primary care population with hypertension without symptoms of heart failure.
DESIGN AND SETTING: A prospective cohort study in five Dutch general practices between 2010-2012 and 2020.
METHOD: In total, 530 patients (aged 60-85 years) underwent laboratory testing, ECGs, and echocardiograms at baseline. The incidence of new CVEs and ACM at up to 9 years' follow-up was recorded by data extraction from the digital information systems.
RESULTS: Among the 530 participants, 31 (5.8%) developed a coronary event, 44 (8.3%) a cerebrovascular accident, 53 (10.0%) atrial fibrillation, 23 (4.3%) heart failure, and 66 (12.5%) died. Cox regression analyses, adjusting for relevant Framingham covariates, showed that elevated BNP increased the risk of ACM, CVEs, and specifically heart failure independently by 44% (hazard ratio [HR] 1.44, 95% confidence interval [CI] = 1.07 to 1.94, P = -0.017), 45% (HR 1.45, 95% CI = 1.15 to 1.82, P = 0.002), and 288% (HR 3.88, 95% CI = 2.13 to 7.10, P<0.001), respectively. LVH on ECG increased the risk of ACM independently by 108% (HR 2.08, 95% CI = 1.14 to 3.81, P = 0.017). LVH either on an ECG and/or echocardiogram increased the risk of heart failure independently by 309% (HR 4.09, 95% CI = 1.34 to 12.49, P = 0.014).
CONCLUSION: In primary care patients with hypertension, BNP seems to be an important marker predicting future CVEs, especially heart failure, as well as all-cause mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - 74(2024), 741 vom: 15. März, Seite e219-e226 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Hartog-Keyzer, Josephine Ml [VerfasserIn] |
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| Links: |
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| Themen: |
Brain natriuretic peptide |
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| Anmerkungen: |
Date Completed 29.03.2024 Date Revised 29.03.2024 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.3399/BJGP.2023.0328 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368500403 |
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| 100 | 1 | |a de Hartog-Keyzer, Josephine Ml |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prediction of cardiovascular events in older patients with hypertension in primary care |b a cohort study |
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| 500 | |a Date Revised 29.03.2024 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Authors. | ||
| 520 | |a BACKGROUND: Accurate risk stratification identifying patients with hypertension at risk of future cardiovascular disease in primary care would be desirable | ||
| 520 | |a AIM: To investigate the association between elevated brain natriuretic peptide (BNP), left ventricular hypertrophy (LVH) on an electrocardiogram (ECG), and LVH on an echocardiogram and the development of cardiovascular events (CVEs), especially heart failure and all-cause mortality (ACM), in a primary care population with hypertension without symptoms of heart failure | ||
| 520 | |a DESIGN AND SETTING: A prospective cohort study in five Dutch general practices between 2010-2012 and 2020 | ||
| 520 | |a METHOD: In total, 530 patients (aged 60-85 years) underwent laboratory testing, ECGs, and echocardiograms at baseline. The incidence of new CVEs and ACM at up to 9 years' follow-up was recorded by data extraction from the digital information systems | ||
| 520 | |a RESULTS: Among the 530 participants, 31 (5.8%) developed a coronary event, 44 (8.3%) a cerebrovascular accident, 53 (10.0%) atrial fibrillation, 23 (4.3%) heart failure, and 66 (12.5%) died. Cox regression analyses, adjusting for relevant Framingham covariates, showed that elevated BNP increased the risk of ACM, CVEs, and specifically heart failure independently by 44% (hazard ratio [HR] 1.44, 95% confidence interval [CI] = 1.07 to 1.94, P = -0.017), 45% (HR 1.45, 95% CI = 1.15 to 1.82, P = 0.002), and 288% (HR 3.88, 95% CI = 2.13 to 7.10, P<0.001), respectively. LVH on ECG increased the risk of ACM independently by 108% (HR 2.08, 95% CI = 1.14 to 3.81, P = 0.017). LVH either on an ECG and/or echocardiogram increased the risk of heart failure independently by 309% (HR 4.09, 95% CI = 1.34 to 12.49, P = 0.014) | ||
| 520 | |a CONCLUSION: In primary care patients with hypertension, BNP seems to be an important marker predicting future CVEs, especially heart failure, as well as all-cause mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a brain natriuretic peptide | |
| 650 | 4 | |a cardiovascular diseases | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a left ventricular hypertrophy | |
| 650 | 4 | |a primary health care | |
| 700 | 1 | |a Pop, Victor Jm |e verfasserin |4 aut | |
| 700 | 1 | |a Rodwell, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Nijveldt, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Messaoudi, Saloua El |e verfasserin |4 aut | |
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