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实体器官移植后高血压及未控制高血压的患病率:瑞士移植队列研究的5年随访

Prevalence of hypertension and uncontrolled hypertension after solid organ transplantation: a 5-year follow-up of the Swiss Transplant Cohort Study.

作者信息

Schwotzer Nora, Lu Yimin, Halfon Matthieu, Pascual Manuel, Marques-Vidal Pedro, Golshayan Dela, Wuerzner Gregoire

机构信息

Service of Nephrology and Hypertension.

Transplantation Center, Departments of Medicine and Surgery.

出版信息

J Hypertens. 2025 Mar 1;43(3):397-404. doi: 10.1097/HJH.0000000000003905. Epub 2024 Oct 23.

Abstract

OBJECTIVE

Hypertension (HTN) increases cardiovascular risk and is a frequent finding across all solid organ transplant recipients. We describe the prevalence of HTN and uncontrolled HTN, as well as details on pharmacologic treatment of HTN across solid organs transplant recipients up to five years after transplantation.

METHODS

This retrospective study is nested in the prospective Swiss Transplant Cohort Study ( www.stcs.ch ) that includes kidney, heart, lung, and liver transplantation. Data extraction from 2008 to 2019 was used for this study and follow-up data at 6, 12 and 60 months was analyzed.

RESULTS

A total of 3865 transplant recipients were included for analysis. The prevalence of HTN at 6 and 60 months was 88.9% and 90.4% in kidney ( P  = 0.21), 61.8% and 76.1% in liver ( P  < 0.01), 72.6% and 84.9% in lung ( P  < 0.01), and 89.3% and 85.8% in heart ( P  = 0.33) transplant recipients, respectively. The prevalence of uncontrolled HTN at 6 and 60 months was 40.3% and 38.9% in kidney ( P  = 0.48), 21.2% and 30.5% in liver ( P  = 0.05), 26.0% and 36.8% in lung ( P  = 0.03) and 38.9% and 18.5% in heart ( P  < 0.01) transplant recipients, respectively. At 12 months, compared to heart transplant recipients, kidney [odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.1-2.1], liver (OR = 1.7, 95% CI 1.1-2.6) and lung (OR = 2.6, 95% CI 1.6-4.0) transplant recipients had a higher likelihood of presenting with uncontrolled HTN.

CONCLUSION

HTN prevalence after solid organ transplantation is high. Uncontrolled and untreated HTN remain a major issue post transplantation, particularly in organ recipients not necessarily suffering from cardiovascular diseases such as liver or lung transplant recipients.

摘要

目的

高血压(HTN)会增加心血管疾病风险,在所有实体器官移植受者中都很常见。我们描述了高血压和未控制的高血压的患病率,以及实体器官移植受者在移植后长达五年的高血压药物治疗细节。

方法

这项回顾性研究嵌套在前瞻性瑞士移植队列研究(www.stcs.ch)中,该研究包括肾、心、肺和肝移植。本研究使用了2008年至2019年的数据提取,并分析了6个月、12个月和60个月时的随访数据。

结果

共有3865名移植受者纳入分析。肾移植受者在6个月和60个月时高血压的患病率分别为88.9%和90.4%(P = 0.21),肝移植受者为61.8%和76.1%(P < 0.01),肺移植受者为72.6%和84.9%(P < 0.01),心脏移植受者为89.3%和85.8%(P = 0.33)。肾移植受者在6个月和60个月时未控制高血压的患病率分别为40.3%和38.9%(P = 0.48),肝移植受者为21.2%和30.5%(P = 0.05),肺移植受者为26.0%和36.8%(P = 0.03),心脏移植受者为38.9%和18.5%(P < 0.01)。在12个月时,与心脏移植受者相比,肾移植受者[比值比(OR)= 1.6,95%置信区间(CI)1.1 - 2.1]、肝移植受者(OR = 1.7,95% CI 1.1 - 2.6)和肺移植受者(OR = 2.6,95% CI 1.6 - 4.0)出现未控制高血压的可能性更高。

结论

实体器官移植后高血压患病率很高。未控制和未治疗的高血压仍然是移植后的一个主要问题,特别是在不一定患有心血管疾病的器官受者中,如肝或肺移植受者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72f3/11789600/00026e48b1a1/jhype-43-397-g001.jpg

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