Volume 20 Issue 7
Jul.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(7): 1147-1150
HU Fang-ying, FANG Hong-wei, LIN Ping, ZHANG Qiu-shi, MA Jing, CHEN Yue-fang. Study on the effect of increased creatinine level after antihypertensive treatment on the risk of cardiovascular events in patients[J]. Chinese Journal of General Practice, 2022, 20(7): 1147-1150. doi: 10.16766/j.cnki.issn.1674-4152.002544
Citation: HU Fang-ying, FANG Hong-wei, LIN Ping, ZHANG Qiu-shi, MA Jing, CHEN Yue-fang. Study on the effect of increased creatinine level after antihypertensive treatment on the risk of cardiovascular events in patients[J]. Chinese Journal of General Practice, 2022, 20(7): 1147-1150. doi: 10.16766/j.cnki.issn.1674-4152.002544
shu

Study on the effect of increased creatinine level after antihypertensive treatment on the risk of cardiovascular events in patients

doi: 10.16766/j.cnki.issn.1674-4152.002544
  • 1.

    Department of Geriatrics, Hangzhou Third People's Hospital, Hangzhou, Zhejiang 310009, China

Funds:

 2020KY724

  • Received Date: 2021-09-01
    Available Online: 2022-09-23
    Abstract
  •   Objective  Decreased renal function associated with renin-angiotensin inhibitors in antihypertensive therapy is associated with an increased risk of cardiovascular disease. However, few studies on other antihypertensive drugs are available. This study aimed to investigate the incidence of cardiovascular events associated with elevated plasma creatinine following first-line antihypertensive medication.  Methods  A total of 182 patients with hypertension who visited Hangzhou Third People's Hospital from October 2015 to June 2020 were enrolled, including 96 males and 86 females, aged (60.5±6.4) years. All patients received renin-angiotensin inhibitors, calcium channel blockers or thiazide antihypertensives during this time period. The correlation between the incidence of 6-month cardiovascular events (ischemic cardiomyopathy, heart failure or stroke) and elevated creatinine was explored.  Results  In accordance with creatinine level, the patients were divided into group A (0%-9%, 79 cases), group B (10%-19%, 40 cases), group C (20%-29%, 27 cases), group D (30%-39%, 20 cases) and group E (>40%, 16 cases). Amongst them, 43.4% (79/182) of patients had an elevated creatinine level of 0%-9%. Six cardiovascular events (3.3%) occurred during the 6-month follow-up period, and no patient died. The creatinine elevations of 0%-9% and 30%-39% corresponded to 6-month cardiovascular event rates of 0.6% and 3.4%, respectively. The total follow-up time was 3.1 (1.8, 5.8) years, the overall incidence of cardiovascular events was 8.2% (15/182) and the incidence in groups D and E was significantly higher than that in other groups (P < 0.001). Higher age and reduced renal function were strongly associated with increased odds of cardiovascular events but not with type of antihypertensive medication.  Conclusion  A greater than 30% increase in plasma creatinine levels in patients starting first-line antihypertensive therapy in primary prevention is associated with increased short-term (6 months) and long-term (3 years) incidence of cardiovascular events.

     

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