Prevalence and Associated Factors for Arterial Hypertension in Adults Following Hematopoietic Stem Cell Transplantation
Background: Survivors of hematopoietic stem cell transplantation (HSCT) are 2 to 4 times more likely to develop cardiovascular diseases, accounting for 2-11% of mortality among long-term survivors. Early diagnosis and treatment of modifiable risk factors, such as arterial hypertension, are imperativ...
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creator | Chalela, Claudia Marcela Uribe, Juan Carlos Luna-Gonzalez, Maria Peña, Angela María Jimenez, Sara Ines Salazar, Luis Antonio Rosales, Manuel Ardila-Baez, Manuel Espinosa, Katherine Baez, Julian Reyes, David Leonardo Rey, Juan Jose Serrano, Sergio Sandoval-Sus, Jose Sossa, Claudia Lucia |
description | Background: Survivors of hematopoietic stem cell transplantation (HSCT) are 2 to 4 times more likely to develop cardiovascular diseases, accounting for 2-11% of mortality among long-term survivors. Early diagnosis and treatment of modifiable risk factors, such as arterial hypertension, are imperative in this group of patients. The aim of this study is to evaluate the prevalence and associated factors for arterial hypertension following HSCT in a Colombian population.
Methods: A retrospective study was conducted in 220 consecutive adult HSCT recipients who underwent transplantation between 2009 and 2017 at a third level referral center in Colombia. Blood pressure data, from two different measures, were collected at 7 time points: day of mobilization for autologous HSCT (auto-HSCT) and day 0 before infusion for allogeneic HSCT (allo-HSCT), day 7, and months 1, 3, 6 and 12 post-HSCT. Arterial hypertension was defined as a systolic blood pressure 140mmHg and/or a diastolic blood pressure 90 mmHg. Patients with history of arterial hypertension were excluded. Descriptive statistics were used to analyze patient's demographic data. Bivariate and multivariate analyses were performed to assess the association between clinical characteristics and arterial hypertension.
Results: One hundred and seventy-one patients were included, with a median age of 45 years (range 18-71). Eighty-nine patients (52.1%) were male. One hundred and fifteen patients (67.3%) underwent auto-HSCT and 56 (32.7%) allo-HSCT. The most common indication for HSCT were lymphomas (39.8%), followed by leukemia (28.6%) and multiple myeloma (23.4%).
Thirty-six patients (21.1%) developed arterial hypertension by the end of the first year of follow-up. Prevalence of hypertension at each time point was 2.3% on day 7 post-HSCT, 4.7%, 5.3%, 5.5% and 8.1% at 1, 3, 6 and 12 months respectively. Allo-HSCT (P |
doi_str_mv | 10.1182/blood-2019-129321 |
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Methods: A retrospective study was conducted in 220 consecutive adult HSCT recipients who underwent transplantation between 2009 and 2017 at a third level referral center in Colombia. Blood pressure data, from two different measures, were collected at 7 time points: day of mobilization for autologous HSCT (auto-HSCT) and day 0 before infusion for allogeneic HSCT (allo-HSCT), day 7, and months 1, 3, 6 and 12 post-HSCT. Arterial hypertension was defined as a systolic blood pressure 140mmHg and/or a diastolic blood pressure 90 mmHg. Patients with history of arterial hypertension were excluded. Descriptive statistics were used to analyze patient's demographic data. Bivariate and multivariate analyses were performed to assess the association between clinical characteristics and arterial hypertension.
Results: One hundred and seventy-one patients were included, with a median age of 45 years (range 18-71). Eighty-nine patients (52.1%) were male. One hundred and fifteen patients (67.3%) underwent auto-HSCT and 56 (32.7%) allo-HSCT. The most common indication for HSCT were lymphomas (39.8%), followed by leukemia (28.6%) and multiple myeloma (23.4%).
Thirty-six patients (21.1%) developed arterial hypertension by the end of the first year of follow-up. Prevalence of hypertension at each time point was 2.3% on day 7 post-HSCT, 4.7%, 5.3%, 5.5% and 8.1% at 1, 3, 6 and 12 months respectively. Allo-HSCT (P<0.001), diagnosis of leukemia (P<0.001) or lymphoma (P<0.05), therapy with calcineurin inhibitors (P=0.004), prophylactic treatment for GvHD with mycophenolate (P<0.05) and acute GvHD (P<0.001) were significantly associated with the development of arterial hypertension. After performing multivariate regression analysis to identify arterial hypertension associated factors, patients with allo-HSCT were found to be 3 times more likely to develop arterial hypertension than patients with auto-HSCT (95% CI 1.85-8.60, P=0.000).
Conclusions: Screening for arterial hypertension is warranted in HSCT survivors since it is a modifiable cardiovascular risk factor. Similar to previously reported findings, we found an association between post-HSCT arterial hypertension and allo-HSCT, use of calcineurin inhibitors and mycophenolate, and development of acute GvHD. Patients undergoing allo-HSCT are at increased risk of developing hypertension.
Sandoval-Sus:Seattle Genetics: Membership on an entity's Board of Directors or advisory committees.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2019-129321</identifier><language>eng</language><publisher>Elsevier Inc</publisher><ispartof>Blood, 2019-11, Vol.134 (Supplement_1), p.5689-5689</ispartof><rights>2019 American Society of Hematology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1421-94f70f56061f3597e7f365df5abc00dd81644aaf07df1962e1ca32a2ffd259f13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>Chalela, Claudia Marcela</creatorcontrib><creatorcontrib>Uribe, Juan Carlos</creatorcontrib><creatorcontrib>Luna-Gonzalez, Maria</creatorcontrib><creatorcontrib>Peña, Angela María</creatorcontrib><creatorcontrib>Jimenez, Sara Ines</creatorcontrib><creatorcontrib>Salazar, Luis Antonio</creatorcontrib><creatorcontrib>Rosales, Manuel</creatorcontrib><creatorcontrib>Ardila-Baez, Manuel</creatorcontrib><creatorcontrib>Espinosa, Katherine</creatorcontrib><creatorcontrib>Baez, Julian</creatorcontrib><creatorcontrib>Reyes, David Leonardo</creatorcontrib><creatorcontrib>Rey, Juan Jose</creatorcontrib><creatorcontrib>Serrano, Sergio</creatorcontrib><creatorcontrib>Sandoval-Sus, Jose</creatorcontrib><creatorcontrib>Sossa, Claudia Lucia</creatorcontrib><title>Prevalence and Associated Factors for Arterial Hypertension in Adults Following Hematopoietic Stem Cell Transplantation</title><title>Blood</title><description>Background: Survivors of hematopoietic stem cell transplantation (HSCT) are 2 to 4 times more likely to develop cardiovascular diseases, accounting for 2-11% of mortality among long-term survivors. Early diagnosis and treatment of modifiable risk factors, such as arterial hypertension, are imperative in this group of patients. The aim of this study is to evaluate the prevalence and associated factors for arterial hypertension following HSCT in a Colombian population.
Methods: A retrospective study was conducted in 220 consecutive adult HSCT recipients who underwent transplantation between 2009 and 2017 at a third level referral center in Colombia. Blood pressure data, from two different measures, were collected at 7 time points: day of mobilization for autologous HSCT (auto-HSCT) and day 0 before infusion for allogeneic HSCT (allo-HSCT), day 7, and months 1, 3, 6 and 12 post-HSCT. Arterial hypertension was defined as a systolic blood pressure 140mmHg and/or a diastolic blood pressure 90 mmHg. Patients with history of arterial hypertension were excluded. Descriptive statistics were used to analyze patient's demographic data. Bivariate and multivariate analyses were performed to assess the association between clinical characteristics and arterial hypertension.
Results: One hundred and seventy-one patients were included, with a median age of 45 years (range 18-71). Eighty-nine patients (52.1%) were male. One hundred and fifteen patients (67.3%) underwent auto-HSCT and 56 (32.7%) allo-HSCT. The most common indication for HSCT were lymphomas (39.8%), followed by leukemia (28.6%) and multiple myeloma (23.4%).
Thirty-six patients (21.1%) developed arterial hypertension by the end of the first year of follow-up. Prevalence of hypertension at each time point was 2.3% on day 7 post-HSCT, 4.7%, 5.3%, 5.5% and 8.1% at 1, 3, 6 and 12 months respectively. Allo-HSCT (P<0.001), diagnosis of leukemia (P<0.001) or lymphoma (P<0.05), therapy with calcineurin inhibitors (P=0.004), prophylactic treatment for GvHD with mycophenolate (P<0.05) and acute GvHD (P<0.001) were significantly associated with the development of arterial hypertension. After performing multivariate regression analysis to identify arterial hypertension associated factors, patients with allo-HSCT were found to be 3 times more likely to develop arterial hypertension than patients with auto-HSCT (95% CI 1.85-8.60, P=0.000).
Conclusions: Screening for arterial hypertension is warranted in HSCT survivors since it is a modifiable cardiovascular risk factor. Similar to previously reported findings, we found an association between post-HSCT arterial hypertension and allo-HSCT, use of calcineurin inhibitors and mycophenolate, and development of acute GvHD. Patients undergoing allo-HSCT are at increased risk of developing hypertension.
Sandoval-Sus:Seattle Genetics: Membership on an entity's Board of Directors or advisory committees.</description><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp90M1KAzEQwPEgCtbqA3jLC6xmsl9dPJVirSAoWM9hmkwkkm6WJLb07d1az55mLv9h-DF2C-IOYCbvNz4EU0gBXQGyKyWcsQnUclYIIcU5mwghmqLqWrhkVyl9CQFVKesJ279F2qGnXhPH3vB5SkE7zGT4EnUOMXEbIp_HTNGh56vDQOPeJxd67no-N98-J74M3oe96z_5iraYwxAcZaf5e6YtX5D3fB2xT4PHPmMe22t2YdEnuvmbU_axfFwvVsXL69PzYv5SaKgkFF1lW2HrRjRgy7prqbVlUxtb40YLYcwMmqpCtKI1FrpGEmgsJUprjaw7C-WUwemujiGlSFYN0W0xHhQIdZRTv3LqKKdOcmPzcGpofGznKKqk3VHIuEg6KxPcP_UPKUN5CQ</recordid><startdate>20191113</startdate><enddate>20191113</enddate><creator>Chalela, Claudia Marcela</creator><creator>Uribe, Juan Carlos</creator><creator>Luna-Gonzalez, Maria</creator><creator>Peña, Angela María</creator><creator>Jimenez, Sara Ines</creator><creator>Salazar, Luis Antonio</creator><creator>Rosales, Manuel</creator><creator>Ardila-Baez, Manuel</creator><creator>Espinosa, Katherine</creator><creator>Baez, Julian</creator><creator>Reyes, David Leonardo</creator><creator>Rey, Juan Jose</creator><creator>Serrano, Sergio</creator><creator>Sandoval-Sus, Jose</creator><creator>Sossa, Claudia Lucia</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191113</creationdate><title>Prevalence and Associated Factors for Arterial Hypertension in Adults Following Hematopoietic Stem Cell Transplantation</title><author>Chalela, Claudia Marcela ; Uribe, Juan Carlos ; Luna-Gonzalez, Maria ; Peña, Angela María ; Jimenez, Sara Ines ; Salazar, Luis Antonio ; Rosales, Manuel ; Ardila-Baez, Manuel ; Espinosa, Katherine ; Baez, Julian ; Reyes, David Leonardo ; Rey, Juan Jose ; Serrano, Sergio ; Sandoval-Sus, Jose ; Sossa, Claudia Lucia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1421-94f70f56061f3597e7f365df5abc00dd81644aaf07df1962e1ca32a2ffd259f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chalela, Claudia Marcela</creatorcontrib><creatorcontrib>Uribe, Juan Carlos</creatorcontrib><creatorcontrib>Luna-Gonzalez, Maria</creatorcontrib><creatorcontrib>Peña, Angela María</creatorcontrib><creatorcontrib>Jimenez, Sara Ines</creatorcontrib><creatorcontrib>Salazar, Luis Antonio</creatorcontrib><creatorcontrib>Rosales, Manuel</creatorcontrib><creatorcontrib>Ardila-Baez, Manuel</creatorcontrib><creatorcontrib>Espinosa, Katherine</creatorcontrib><creatorcontrib>Baez, Julian</creatorcontrib><creatorcontrib>Reyes, David Leonardo</creatorcontrib><creatorcontrib>Rey, Juan Jose</creatorcontrib><creatorcontrib>Serrano, Sergio</creatorcontrib><creatorcontrib>Sandoval-Sus, Jose</creatorcontrib><creatorcontrib>Sossa, Claudia Lucia</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chalela, Claudia Marcela</au><au>Uribe, Juan Carlos</au><au>Luna-Gonzalez, Maria</au><au>Peña, Angela María</au><au>Jimenez, Sara Ines</au><au>Salazar, Luis Antonio</au><au>Rosales, Manuel</au><au>Ardila-Baez, Manuel</au><au>Espinosa, Katherine</au><au>Baez, Julian</au><au>Reyes, David Leonardo</au><au>Rey, Juan Jose</au><au>Serrano, Sergio</au><au>Sandoval-Sus, Jose</au><au>Sossa, Claudia Lucia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Associated Factors for Arterial Hypertension in Adults Following Hematopoietic Stem Cell Transplantation</atitle><jtitle>Blood</jtitle><date>2019-11-13</date><risdate>2019</risdate><volume>134</volume><issue>Supplement_1</issue><spage>5689</spage><epage>5689</epage><pages>5689-5689</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><abstract>Background: Survivors of hematopoietic stem cell transplantation (HSCT) are 2 to 4 times more likely to develop cardiovascular diseases, accounting for 2-11% of mortality among long-term survivors. Early diagnosis and treatment of modifiable risk factors, such as arterial hypertension, are imperative in this group of patients. The aim of this study is to evaluate the prevalence and associated factors for arterial hypertension following HSCT in a Colombian population.
Methods: A retrospective study was conducted in 220 consecutive adult HSCT recipients who underwent transplantation between 2009 and 2017 at a third level referral center in Colombia. Blood pressure data, from two different measures, were collected at 7 time points: day of mobilization for autologous HSCT (auto-HSCT) and day 0 before infusion for allogeneic HSCT (allo-HSCT), day 7, and months 1, 3, 6 and 12 post-HSCT. Arterial hypertension was defined as a systolic blood pressure 140mmHg and/or a diastolic blood pressure 90 mmHg. Patients with history of arterial hypertension were excluded. Descriptive statistics were used to analyze patient's demographic data. Bivariate and multivariate analyses were performed to assess the association between clinical characteristics and arterial hypertension.
Results: One hundred and seventy-one patients were included, with a median age of 45 years (range 18-71). Eighty-nine patients (52.1%) were male. One hundred and fifteen patients (67.3%) underwent auto-HSCT and 56 (32.7%) allo-HSCT. The most common indication for HSCT were lymphomas (39.8%), followed by leukemia (28.6%) and multiple myeloma (23.4%).
Thirty-six patients (21.1%) developed arterial hypertension by the end of the first year of follow-up. Prevalence of hypertension at each time point was 2.3% on day 7 post-HSCT, 4.7%, 5.3%, 5.5% and 8.1% at 1, 3, 6 and 12 months respectively. Allo-HSCT (P<0.001), diagnosis of leukemia (P<0.001) or lymphoma (P<0.05), therapy with calcineurin inhibitors (P=0.004), prophylactic treatment for GvHD with mycophenolate (P<0.05) and acute GvHD (P<0.001) were significantly associated with the development of arterial hypertension. After performing multivariate regression analysis to identify arterial hypertension associated factors, patients with allo-HSCT were found to be 3 times more likely to develop arterial hypertension than patients with auto-HSCT (95% CI 1.85-8.60, P=0.000).
Conclusions: Screening for arterial hypertension is warranted in HSCT survivors since it is a modifiable cardiovascular risk factor. Similar to previously reported findings, we found an association between post-HSCT arterial hypertension and allo-HSCT, use of calcineurin inhibitors and mycophenolate, and development of acute GvHD. Patients undergoing allo-HSCT are at increased risk of developing hypertension.
Sandoval-Sus:Seattle Genetics: Membership on an entity's Board of Directors or advisory committees.</abstract><pub>Elsevier Inc</pub><doi>10.1182/blood-2019-129321</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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title | Prevalence and Associated Factors for Arterial Hypertension in Adults Following Hematopoietic Stem Cell Transplantation |
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