Joint Association of Albuminuria and Left Ventricular Hypertrophy With Incident Heart Failure in Adults at High Risk With Hypertension: A Systolic Blood Pressure Intervention Trial Substudy.

Autor: Ahmad MI; Department of Internal Medicine, Section on Hospital Medicine, Medical College of Wisconsin, Wauwatosa, Wisconsin. Electronic address: miahmad@mcw.edu., Kazibwe R; Department of Internal Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Soliman MZ; Wake Forest University, Winston-Salem, North Carolina., Singh S; Department of Internal Medicine, Section on Hospital Medicine, Medical College of Wisconsin, Wauwatosa, Wisconsin., Chen LY; Lillehei Heart Institute and Cardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota; Cardiovascular Division, University of Minnesota Medical School, Minneapolis, Minnesota., Soliman EZ; Epidemiological Cardiology Research Center, Department of Internal Medicine, Cardiovascular Section, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2023 Dec 01; Vol. 208, pp. 75-82. Date of Electronic Publication: 2023 Oct 09.
DOI: 10.1016/j.amjcard.2023.09.048
Abstrakt: Albuminuria and left ventricular hypertrophy (LVH) are independent predictors of heart failure (HF); however, to the best of our knowledge, their combined effect on the risk of HF has not yet been explored. Therefore, we examined the joint associations of albuminuria and electrocardiographic-LVH with incident acute decompensated HF (ADHF), and whether albuminuria/LVH combinations modified the effects of blood pressure control strategy in reducing the risk of ADHF. A total of 8,511 participants from the Systolic Blood Pressure Intervention Trial (SPRINT) were included. Electrocardiographic-LVH was present if any of the following criteria were present: Cornell voltage, Cornell voltage product, or Sokolow-Lyon. Albuminuria was defined as urine albumin/creatinine ratio ≥30 mg/g. ADHF was defined as hospitalization or emergency department visit for ADHF. Cox proportional hazard models were used to examine the association of neither LVH nor albuminuria (reference), either LVH or albuminuria, and both (LVH + albuminuria) with incident ADHF. Over a median follow-up of 3.2 years, 182 cases of ADHF occurred. In adjusted models, concomitant albuminuria and LVH were associated with greater risk of ADHF than either albuminuria or LVH in isolation (hazard ratio [95% confidence interval]: 4.95 [3.22 to 7.62], 2.04 [1.39 to 3.00], and 1.47 [0.93 to 2.32], respectively, additive interaction p = 0.01). The effect of intensive blood pressure in reducing ADHF was attenuated in participants with coexisting albuminuria and LVH without any interaction between treatment group assignment and albuminuria/LVH categories (interaction p = 0.26). In conclusion, albuminuria and LVH are additive predictors of ADHF. The effect of intensive blood pressure control in reducing ADHF risk did not vary significantly across albuminuria/LVH combinations.
Competing Interests: Declaration of Competing Interest Dr. Chen receives funding from the National Heart, Lung, and Blood Institute (R01 HL141288, R01 HL126637, K24 HL155813). The remaining authors have no competing interests to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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