LVH Predicts Worse Renal Outcomes in Hypertensive Patients

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Left ventricular hypertrophy (LVH) is a significant predictor of adverse renal outcomes in hypertensive patients managed in a primary care setting, according to a study.

Consequently, clinicians should adopt systematic screening for LVH when assessing renal risk in hypertensive patients, investigators concluded.

A study led by Ernesto Paoletti, MD, of the IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy, looked at a data from 18,510 hypertensive patients for whom renal follow-up information was available. The baseline prevalence of chronic kidney disease (CKD) and LVH were 25.6% and 5.6%, respectively. During a five-year follow-up, 1.4% of patients with LVH progressed to end-stage renal disease requiring dialysis compared with 0.5% of subjects without LVH, the researchers reported online ahead of print in the American Journal of Hypertension. In addition, 25.6% of patients with LVH progressed from each stage of CKD to a more advanced stage compared with 17% without LVH, with 0.9% of patients with LVH and 0.4% of patients without LVH reaching stage 5.

After adjusting for multiple variables, LVH was associated with a significant 82% increased likelihood of progressing to dialysis and a 24% increased likelihood of progressing to a more advanced stage of CKD.

The study's findings highlight the need for systematic assessment of cardiac morphology and function in hypertensive patients with electrocardiography-proven LVH through the use of more accurate and reliable tools to identify patients at high risk of worsening renal function, Dr. Paoletti's team concluded.

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