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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Veröffentlicht in:Blood 2019-11, Vol.134 (Supplement_1), p.5689-5689
Hauptverfasser: 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
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container_issue Supplement_1
container_start_page 5689
container_title Blood
container_volume 134
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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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&lt;0.001), diagnosis of leukemia (P&lt;0.001) or lymphoma (P&lt;0.05), therapy with calcineurin inhibitors (P=0.004), prophylactic treatment for GvHD with mycophenolate (P&lt;0.05) and acute GvHD (P&lt;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&lt;0.001), diagnosis of leukemia (P&lt;0.001) or lymphoma (P&lt;0.05), therapy with calcineurin inhibitors (P=0.004), prophylactic treatment for GvHD with mycophenolate (P&lt;0.05) and acute GvHD (P&lt;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. 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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&lt;0.001), diagnosis of leukemia (P&lt;0.001) or lymphoma (P&lt;0.05), therapy with calcineurin inhibitors (P=0.004), prophylactic treatment for GvHD with mycophenolate (P&lt;0.05) and acute GvHD (P&lt;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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