Prevalence and predictors of hypertension in cardiac recipients

Aim . The study was aimed to assess the prevalence and risk factors of hypertension in cardiac recipients. Materials and methods . End-stage heart failure patients who received cardiac transplant between 01.01.2013 and 31.12.2016 in V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Moscow) and survived 3 months after surgery were included and followed up for 999.4 ± 774.3 (108–1587) days. Young patients (<18 y/o) and patients after repeated (n = 18) or multi-organ transplantation (n = 3) were excluded. Results. 353 cardiac recipients aged 45.6 ± 1.6 years (18.1% females and 81.9% males) were enrolled into the study. Hypertension was prevalent in 17.6, 42.8, 62.3 and 71.4%, respectively, before, in 3 months, in 1 year, and 3+ years after the transplantation. The study revealed significant relationship between post-transplant hypertension incidence and pre-op body mass index (р = 0.026), serum creatinine (р < 0.001), preexisting hypertension (RR = 1.36, р = 0.022) and renal failure, as well as donor heart posterior wall thickness (р = 0.034), post-transplant dialysis (RR = 1.85, р < 0.001), and antibody mediated rejection episodes (RR = 1.7, р = 0.001). Uncontrolled hypertension in cardiac recipients was related to poor compliance and new-onset post-transplant renal failure. Conclusion . Hypertension is highly prevalent among our population of cardiac recipients. The combination of various etiologic mechanisms, multiplex therapy and subjective factors calls for the careful individual patient management.