Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
J Clin Hypertens (Greenwich). 2023 Aug;25(8):748-756. doi: 10.1111/jch.14698. Epub 2023 Jul 12.
Hypertension is a chronic disease that requires long-term follow-up in many patients, however, optimal visit intervals are not well-established. This study aimed to evaluate the incidences of major cardiovascular events (MACEs) according to visit intervals. We analyzed data from 9894 hypertensive patients in the Korean Hypertension Cohort, which enrolled and followed up 11,043 patients for over 10 years. Participants were classified into five groups based on their median visit intervals (MVIs) during the 4-year period and MACEs were compared among the groups. The patients were divided into clinically relevant MVIs of one (1013; 10%), two (1299; 13%), three (2732; 28%), four (2355; 24%), and six months (2515; 25%). The median follow-up period was 5 years (range: 1745 ± 293 days). The longer visit interval groups did not have an increased cumulative incidence of MACE (12.9%, 11.8%, 6.7%, 5.9%, and 4%, respectively). In the Cox proportional hazards model, those in the longer MVI group had a smaller hazard ratio (HR) for MACEs or all-cause death: 1.77 (95% confidence interval [CI], 1.45-2.17), 1.7 (95% CI: 1.41-2.05), 0.90 (95% CI: 0.74-1.09) and 0.64 (95% CI: 0.52-0.79), respectively (Reference MVI group of 75-104 days). In conclusion, a follow-up visits with a longer interval of 3-6 months was not associated with an increased risk of MACE or all-cause death in hypertensive patients. Therefore, once medication adjustment is stabilized, a longer interval of 3-6 months is reasonable, reducing medical expenses without increasing the risk of cardiovascular outcomes.
高血压是一种需要许多患者长期随访的慢性病，但最佳就诊间隔尚未确定。本研究旨在根据就诊间隔评估主要心血管事件（MACE）的发生率。我们分析了韩国高血压队列中 9894 名高血压患者的数据，该队列招募并随访了 11043 名患者超过 10 年。根据 4 年内的中位数就诊间隔（MVIs），将参与者分为五组，并比较了各组之间的 MACE 情况。患者被分为临床相关的 MVIs：1 个月（1013 例，10%）、2 个月（1299 例，13%）、3 个月（2732 例，28%）、4 个月（2355 例，24%）和 6 个月（2515 例，25%）。中位随访期为 5 年（范围：1745±293 天）。就诊间隔较长的组 MACE 的累积发生率并没有增加（分别为 12.9%、11.8%、6.7%、5.9%和 4%）。在 Cox 比例风险模型中，就诊间隔较长组的 MACE 或全因死亡的风险比（HR）较小：1.77（95%置信区间 [CI]，1.45-2.17）、1.7（95% CI：1.41-2.05）、0.90（95% CI：0.74-1.09）和 0.64（95% CI：0.52-0.79）（参考 MVI 组为 75-104 天）。总之，在高血压患者中，随访间隔延长至 3-6 个月不会增加 MACE 或全因死亡的风险。因此，一旦药物调整稳定，3-6 个月的较长间隔是合理的，可以降低医疗费用而不会增加心血管结局的风险。
