高血压性病因心力衰竭患者的临床特征和结局：哥伦比亚心力衰竭注册研究（RECOLFACA）分析。
Clinical Characteristics and Outcomes of Patients with Heart Failure of Hypertensive Etiology: Analysis of Colombian Heart Failure Registry (RECOLFACA).
机构信息
Department of Cardiology, Clínica Iberoamérica, Barranquilla, Colombia.
Department of Cardiology, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
出版信息
Kidney Blood Press Res. 2024;49(1):165-172. doi: 10.1159/000535705. Epub 2024 Feb 15.
INTRODUCTION
Arterial hypertension represents one of the main comorbidities observed in patients with heart failure (HF) and one of the main risk factors for its development. Despite this, studies assessing this hypertensive etiology are scarce in Latin America. Our objective was to analyze the prevalence of HF of hypertensive etiology and evaluate its prognosis in patients enrolled in the Colombian Heart Failure Registry (RECOLFACA by its Spanish acronym).
METHODS
RECOLFACA recruited adult patients diagnosed with HF in 60 centers in Colombia between 2017 and 2019. The primary outcome was all-cause mortality. A Cox proportional hazards regression model was used to assess factors associated with primary outcomes in patients with hypertensive HF. A p value <0.05 was considered significant. All statistical tests were two-tailed.
RESULTS
Out of the total number of patients evaluated in RECOLFACA (n = 2,514), 804 had a diagnosis of HF with hypertensive etiology (31.9%). These patients were less frequently males and had a significantly older age and lower prevalence of comorbidities than those with HF of other etiologies. Additionally, patients with hypertensive HF had a higher prevalence of HF with preserved ejection fraction (HFpEF) (34.1% vs. 28.3%; p = 0.004). Finally, type 2 diabetes mellitus, chronic obstructive pulmonary disease diagnosis, and NYHA class IV were classified as independent mortality risk factors.
CONCLUSIONS
Hypertensive HF represents about one-third of the total number of patients with HF in RECOLFACA. Compared with HF of other etiologies, it presents a differential clinical profile - older age and a higher prevalence of HFpEF. RECOLFACA has become a useful tool to characterize patients with HF in Colombia, with which it has been possible to carry out a more specific search and reach the diagnosis of this pathology in our population, and it has served as an example to stimulate registries of patients with HF in other countries in the region.
简介
动脉高血压是心力衰竭（HF）患者中观察到的主要合并症之一，也是其发展的主要危险因素之一。尽管如此，在拉丁美洲，评估这种高血压病因的研究仍然很少。我们的目的是分析高血压性 HF 的患病率，并评估其在 2017 年至 2019 年期间在哥伦比亚 60 个中心确诊为 HF 的患者中登记的 RECOLFACA 注册研究中的预后。
方法
RECOLFACA 招募了 2017 年至 2019 年期间在哥伦比亚 60 个中心确诊为 HF 的成年患者。主要终点是全因死亡率。使用 Cox 比例风险回归模型评估高血压性 HF 患者与主要结局相关的因素。p 值 <0.05 被认为具有统计学意义。所有统计检验均为双侧检验。
结果
在 RECOLFACA 评估的总患者人数（n = 2514）中，有 804 例诊断为高血压性 HF（31.9%）。与其他病因的 HF 患者相比，这些患者男性较少，年龄明显较大，且合并症的患病率较低。此外，高血压性 HF 患者心力衰竭射血分数保留型（HFpEF）的患病率较高（34.1% vs. 28.3%；p = 0.004）。最后，2 型糖尿病、慢性阻塞性肺疾病诊断和 NYHA 心功能 IV 级被归类为独立的死亡风险因素。
结论
高血压性 HF 约占 RECOLFACA 中 HF 患者总数的三分之一。与其他病因的 HF 相比，它具有不同的临床特征——年龄较大，HFpEF 的患病率较高。RECOLFACA 已成为一种有用的工具，可用于描述哥伦比亚的 HF 患者，通过它可以更具体地搜索并在我们的人群中诊断出这种疾病，并成为刺激该地区其他国家 HF 患者登记的榜样。
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