The simultaneous presence of both electrocardiographic left ventricular hypertrophy and renal damage was associated with a 3-fold higher prevalence of established cardiovascular disease (OR 3.12).
Cross-Sectional (n=2,339)
Yes
Does the presence of target organ damage (ECG-LVH or renal damage) associate with an increased prevalence of established cardiovascular disease in patients with hypertension and type 2 diabetes?
In patients with hypertension and type 2 diabetes, the presence of ECG-LVH and/or renal damage is strongly associated with established cardiovascular disease, highlighting the importance of routine target organ damage screening for risk stratification.
Odds Ratio: 3.12 (95% CI 2.33–4.19)
Absolute Event Rate: 70.6% vs 37.7%
p-value: p=<0.001
BACKGROUND: Target organ damage (mainly cardiac and renal damage) is easy to evaluate in outpatient clinics and offers valuable information about patient's cardiovascular risk. The purpose of this study was to evaluate, using simple methods, the prevalence of cardiac and renal damage and its relationship to the presence of established cardiovascular disease (CVD), in patients with hypertension (HT) and type 2 diabetes mellitus (DM). METHODS: The RICARHD study is a multicentre, cross-sectional study made by 293 investigators in Nephrology and Internal Medicine Spanish outpatient clinics, and included patients aged 55 years or more with HT and type 2 DM with more than six months of diagnosis. Demographic, clinical and biochemical data, and CVD were collected from the clinical records. Cardiac damage was defined by the presence of electrocardiographic left ventricular hypertrophy (ECG-LVH), and renal damage by a calculated glomerular filtration rate (GFR) of or = 30 mg/g; or an urinary albumin excretion (UAE) > or = 30 mg/24 hours. RESULTS: 2339 patients (mean age 68.9 years, 48.2% females, 51.3% with established CVD) were included. ECG-LVH was present in 22.9% of the sample, GFR <60 ml/min/1.73 m2 in 45.1%, and abnormal UAE in 58.7%. Compared with the reference patients (those without neither cardiac nor renal damage), patients with ECG-LVH alone (OR 2.20, 95%CI 1.43-3.38), or kidney damage alone (OR 1.41, 1.13-1.75) showed an increased prevalence of CVD. The presence of both ECG-LVH and renal damage was associated with the higher prevalence (OR 3.12, 2.33-4.19). After stratifying by gender, this relationship was present for both, men and women. CONCLUSION: In patients with HT and type 2 DM, ECG-LVH or renal damage, evaluated using simple methods, are associated with an increased prevalence of established CVD. The simultaneous presence of both cardiac and renal damage was associated to the higher prevalence of CVD, affording complementary information. A systematic assessment of cardiac and renal damage complements the risk assessment of these patients with HT and type 2 DM.
Cea‐Calvo et al. (Sun,) conducted a cross-sectional in Hypertension and type 2 diabetes mellitus (n=2,339). Target organ damage (both ECG-LVH and renal damage) vs. No cardiac or renal damage was evaluated on Prevalence of established cardiovascular disease (OR 3.12, 95% CI 2.33-4.19, p=<0.001). The simultaneous presence of both electrocardiographic left ventricular hypertrophy and renal damage was associated with a 3-fold higher prevalence of established cardiovascular disease (OR 3.12).
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