Incidence and risk factors of target organ damage in 17, 682 elderly hypertensive inpatients between 1993 and 2008 / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>The aim of our study was to investigate the prevalence of target organ damage (TOD) in elderly hypertensive inpatients.</p><p><b>METHODS</b>Data of the present retrospective survey were collected and analyzed from the computerized medical records of 17 682 aged 60 years or older inpatients with the diagnosis of essential hypertension (EH) from January 1993 to December 2008 in our hospital. The evidences of hypertensive TOD and associated risk factors with TOD including age, gender, presence of diabetes (DM), body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum lipids were analyzed.</p><p><b>RESULTS</b>The overall prevalence of stroke, coronary artery disease (CAD), chronic kidney disease (CKD) and aortic dissection (AD) was 32.19%, 27.33%, 10.12% and 0.77%, respectively. Incidence of TOD was 68.03% in male and 31.70% in female patients. CKD stage 3-5 was more prevalent in males than in females (12.75% vs. 5.40%, P < 0.01), while the prevalence of CAD (31.31% vs. 27.96%, P = 0.06), Stroke (28.23% vs. 25.81%, P = 0.08) and AD (0.89% vs.0.74%, P = 0.72) was similar between men and women. One TOD was presented in 23.20% patients and two or more TODs were found in 47.19% patients. Higher age and BMI, longer history and lower control rate of hypertension, severe degree of hypertension and higher level of SBP, pulse pressure, TC, LDL-C, estimated GFR (eGFR) and Hcy were risk factors for TOD. BMI, fasting plasma glucose, incidence of DM, prevalence of stage 1 and 2 hypertension, control rate of hypertension, eGFR and TG levels were all significantly higher while the prevalence of hypertension stage 3 and level of TC and LDL-C were significantly lower in female TOD patients than in male TOD patients (all P < 0.05). In patients without TOD, TG was significantly higher while SBP, fasting plasma glucose and LDL-C were significantly lower and history of hypertension was significantly shorter in female patients than in male patients (all P < 0.05). The prevalence of CAD, stroke and CKD increased with age (P < 0.001).</p><p><b>CONCLUSION</b>The prevalence of TOD is high in elderly hypertensive inpatients and higher age and BMI, longer history and lower control rate of hypertension, severe degree of hypertension and higher level of SBP, pulse pressure, TC, LDL-C, eGFR and Hcy are risk factors for TOD.</p>