TY  - JOUR
A1  - Reibis, Rona Katharina
A1  - Huber, Matthias
A1  - Karoff, Marthin
A1  - Kamke, Wolfram
A1  - Kreutz, Reinhold
A1  - Wegscheider, Karl
A1  - Völler, Heinz
T1  - Target organ damage and control of cardiovascular risk factors in hypertensive patients Evidence from the multicenter ESTher registry
JF  - Herz : cardiovascular diseases
N2  - This study investigated the incidence of hypertensive target organ damage (TOD), control of cardiovascular risk factors, and the short-term prognosis in hypertensive patients under contemporary guideline-oriented therapy.
 A total of 1,377 consecutive patients (mean age 58.2 +/- 9.9 years, 82.2 % male) with arterial hypertension were included in the ESTher (Endorganschaden, Therapie und Verlauf - target organ damage, therapy, and course) registry at 15 rehabilitation clinics within the framework of the National Genome Research Network. Cardiovascular risk factors, medication, comorbidities, and glomerular filtration rate (GFR) were assessed. Left ventricular hypertrophy (LVH), left ventricular mass (LVM), left ventricular mass index (LVMI), and left ventricular ejection fraction (LVEF) were determined by two-dimensional echocardiography. The mean follow-up was 513 +/- 159 days. Changes in continuous parameters were tested by the t test, changes in discrete characteristics are presented by means of transition tables and tested with the McNemar test.
 The mean LVEF was 59.3 +/- 9.9 %, both mean LVM (238.6 +/- 101.5 g) and LVMI (54.0 +/- 23.6 g/m(2.7)) were increased while relative wall thickness (RWT, 0.46 +/- 0.18) indicated the presence of concentric LVH. Of the patients, 10.2 % displayed renal dysfunction (estimated GFR < 60 ml/min/1.73 m(2)). The 1.5-year overall mortality was 1.2 %. Compared with discharge, at follow-up the proportion of patients with blood pressure (BP) values < 140/90 mmHg decreased from 68.7 % to 55.0 % (p < 0.001) and with low-density lipoprotein (LDL) values < 100 mg/dl from 62.6 % to 38.1 % (p < 0.001). At follow-up significantly more patients displayed a GFR value of < 60 ml/min/1.73 m(2) (10.2 % vs. 16.0 %, p < 0.001).
 A significant proportion of hypertensive rehabilitation participants displayed TOD including LVH and renal dysfunction. Even after stringent BP reduction, a considerable increase in nephropathy could be found after 18 months.
KW  - Arterial hypertension
KW  - Prospective study
KW  - Left ventricular hypertrophy
KW  - Glomerular filtration rate
KW  - Cardiac rehabilitation
Y1  - 2015
U6  - https://doi.org/10.1007/s00059-014-4189-8
SN  - 0340-9937
SN  - 1615-6692
VL  - 40
SP  - 209
EP  - 216
PB  - Urban & Vogel
CY  - München
ER  -