ప్రాథమిక సంరక్షణలో నాణ్యత అందరికి ప్రవేశం

నైరూప్య

Hypertensive Heart Disease Predicitive Index

Gilberto Peña Sánchez, Alexis Álvarez- Aliaga, Julio César González-Aguilera, Liliana del Rosario Maceo-Gómez, Adonis Frómeta-Guerra

Introduction: Hypertensive cardiopathy exhibits a high morbidity and mortality worldwide. The complexity for its prevention depends on the number of risk factors involved.

Objective: To design and validate a hypertensive cardiopathy predictive index based on risk factors which permit to predict the development of hypertensive cardiopathy in patients who suffer from arterial hypertension.

Method: An analytical study was carried out in which case and control hypertensive patients were paired off by sex and followed up by the Arterial Hypertensive Outpatient Department at “Carlos Manuel de Céspedes” General University Hospital of Bayamo, Granma, Cuba from January 1st, 2004 to December 31st, 2009. The sample consisted of 1200 individuals. An index was constructed based on independent risk factors and internal and external validation was carried out.

Results: The logistic regression model showed that the factor with greater importance was C-reactive protein (OR=10, 98; CI 95%=6.350-19,002; p=0,000) followed by glycemia greater than 5, 4 mmol/L (OR=5, 01); both the index discriminative capacity (area under the curve was 0,957; IC 95%=0,934-0,980; p=0,000) and the calibration were adequate (Hosmer and Lemeshow; p=0,783). The validation process was satisfactory.

Conclusion: Both indexes obtained and validated permit to predict accurately and reliably the development of hypertensive cardiopathy, so its introduction in clinical practice can improve the evaluation of hypertensive patients.