Banierink, E.G.M. (2016) Factoren die cardiovasculaire complicaties voorspellen bij primaire preventie van patiënten met hypertensie in de huisartsenpraktijk. thesis, Medicine.
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Abstract
Background: The risk of cardiovascular complications is multifactorial. Therefore the treatment of a patient with an increased risk is based on all major risk factors in that patient. However, it is unknown which combination of risk factors cause the highest actual risk for cardiovascular complications in patients with hypertension, who are treated by the general practitioner, because of primary prevention of cardiovascular disease. Objective: In this study, we investigate the risk factors that predict the development of cardiovascular complications in patients with hypertension and primary prevention of cardiovascular disease. Methods: A retrospective cohort study was done at THOON B.V. Hengelo with three general practices concerning January 2007 until October 2015. There were 1344 patients enrolled, all treated for primary prevention in hypertension. Various search parameters have been investigated to reveal the predictors for the development of cardiovascular events. With those parameters a multivariate predictive model was developed. Results: Off all patients, 26% developed a cardiovascular event. In the univariate analysis, thirteen risk factors with a significant relationship with time to develop an event were found. A multivariate model with six significant predictors was developed, in which age (Hazard Ratio (HR) 1,038 95% BI 1,027-1,050)), gender (HR 1,284 95% BI 1,023-1,612), weight (HR 1,009 95% BI 1,002-1,016), systolic blood pressure (HR 1,044 95% BI 0,993-1,098) and COPD (HR 2,166 95% BI 1,556-3,014) are significant predictive factors for time to develop a cardiovascular event. Therapy resistant hypertension at baseline will predict the development of a cardiovascular event too (HR 2,329 95% BI 1,597-3,396). Conclusion: Age, gender, weight, systolic blood pressure and COPD are independent risk factors for the development of a cardiovascular event in patients with hypertension following a general practitioners’ primary prevention program for cardiovascular disease. Weight and systolic blood pressure are variables which could be acted on. Therefore it would be useful for general practitioners to focus on those factors in patients with hypertension and primary prevention of cardiovascular disease.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Palen, Prof. Dr. Job van der (epidemioloog) |
| Supervisor name: | Dagelijks begeleider: and Vliet Suzan van (huisarts) and Twentse Huisartsen Onderneming Oost Nederland (THOON) and Hengelo, Overijssel |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1116 |
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