Predictor factors for the development of arterial hypertension following heart transplantation

Clin Transplant. 2008 Nov-Dec;22(6):760-4. doi: 10.1111/j.1399-0012.2008.00875.x. Epub 2008 Aug 18.

Abstract

Introduction: Up to 95% of the patients with heart transplantation (HT) suffer from arterial hypertension (AHT). The development of de novo AHT after HT has not been greatly studied.

Aim: To identify the predictor variables for the development of de novo AHT after HT.

Materials and methods: We retrospectively studied 253 patients with HT and who did not previously have AHT. We excluded cases of early mortality, re-transplants and combined transplants. We considered AHT as the constant need to take anti-hypertensive drugs to maintain blood pressure < 140/90 mmHg. We studied all the variables relating to recipient, donor, surgical procedure, immunosuppression and follow-up. The statistics used were the Student's t-test, chi-square statistic and a logistic regression analysis.

Results: Of the 253 patients, 109 (43%) developed AHT. The variables associated with more prevalent AHT were male recipient/donor, idiopathic dilated cardiomyopathy (IDCM) as cause of HT, having been a smoker as well as renal deterioration (RD) and hypercholesterolemia after HT. The multivariate analysis found smoking prior to the HT and hypercholesterolemia during follow-up as independent risk factors and urgent HT as a protective variable.

Conclusions: AHT after HT is frequent. The variables associated in our population were smoking before HT, male recipient/donor, IDCM prior to HT and hypercholesterolemia and RD after HT.

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use
  • Cardiomyopathies / etiology
  • Cardiomyopathies / pathology
  • Female
  • Follow-Up Studies
  • Heart Transplantation / adverse effects*
  • Humans
  • Hypercholesterolemia / etiology
  • Hypercholesterolemia / pathology
  • Hypertension / diagnosis
  • Hypertension / etiology*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Renal Insufficiency / etiology
  • Renal Insufficiency / pathology
  • Retrospective Studies

Substances

  • Antihypertensive Agents