069 Main risk factors leading from arterial hypertension to heart failure – The O-PREDICT 2 study

While the major role played by hypertension (HT) in the genesis of chronic heart failure (HF) is well known, the main risk factors leading to HF in hypertensive patients remain poorly investigated. O-PREDICT 2 was a multicentre, observational study conducted with 1537 general practitioners who recruited 4427 consecutive hypertensive outpatients (pts) (mean age 72±9 years; 66% males). We compared pts with a clinical history of HF (group 1, n=2969) and without HF (group 2, n=1458, age > 65 yrs).ResultsSex ratio and age were similar between groups. Duration of HT was higher (P<.05) in group 1 (14± 8 vs. 11± 8 years in group 2). Blood pressure was lower in group 1, with 49.4% pts having SBP ≥ 140 mmHg vs. 60.9% in group 2. The number of cardiovascular risk factors ranged from 0 to 11 with a median of 4 in group 1, and from 0 to 10 with a median of 2 in group 2; 74.3% of pts in group 1 vs. 45.6% in group 2 had more than 3 risks factors (P<.05). Using multivariate analysis, left ventricular hypertrophy (LVH) was the strongest risk factor of HF (OR= 25.4, 95%CI=21-31), followed by the presence of heart valve disease (OR=4.1, 95%CI=2.7-6.3), paroxystic or permanent atrial fibrillation (OR=4.05, 95%CI=3.1-5.3), renal dysfunction, history of myocardial infarction and coronary artery disease (OR<3 for each of them).ConclusionAs suspected, LVH is the strongest risk factor for HF in hypertension, while a majority of pts presented with > 3 risk factors for HF. This study highlights the need for an early management of HF risk factors in hypertensive pts