Target Organ Damage and the Long Term Effect of Nonadherence to Clinical Practice Guidelines in Patients with Hypertension: A Retrospective Cohort Study
Table 4
Predictors of the target organ damage due to hypertension: multivariate cox regression.
Variables
Complication (yes)
Complication (no)
CHR (95%)
AHR (95% CI)
Sex (Male)
126 (20.59)
145 (23.69)
0.902 (0.693–1.174)
0.768 (0.563–1.145)
Residence (rural)
78 (12.75)
75 (12.25)
1.245 (0.923–1.679)
1.261 (0.824–1.759)
Presence of comorbidities
118 (19.3)
104 (16.99)
1.073 (1.01–1.437)
1.596 (1.174–1.637)
HTN (diastolic)
21 (3.43)
29 (4.74)
0.782 (0.57–1.087)
0.635 (0.448–1.536)
Both
179 (29.25)
223 (36.44)
0.713 (0.387–1.831)
0.526 (0.327–1.725)
Duration of appointment
Two months
118 (19.28)
146 (23.6)
2.167 (0.295–5.19)
4.548 (0.591–6.423)
≥Three months
35 (5.72)
77 (12.58)
1.176 (0.776–1.781)
1.094 (0.709–1.689)
Controlled BP
199 (32.52)
282 (46.10)
0.605 (0.411–0.839)
0.771 (0.507–0.974)
Discordant with JNC
176 (28.76)
279 (45.59)
1.537 (1.167–2.024)
1.636 (1.189–2.251)
Absence of regimen change
191 (31.21)
312 (50.98)
1.702 (1.240–2.336)
1.857 (1.325–2.602)
Therapy
Dual therapy
138 (22.55)
153 (25.0)
0.832 (0.642–1.080)
0.79 (0.473–1.786)
Triple therapy
56 (9.15)
53 (8.66)
0.715 (0.511–1.001)
1.317 (0.629–1.852)
Age
31–40
32 (5.23)
41 (6.70)
0.75 (0.349–1.612)
0.732 (0.332–1.617)
41–50
44 (7.19)
53 (8.66)
0.995 (0.621–1.594)
0.975 (0.599–1.587)
51–60
60 (9.80)
98 (16.01)
0.89 (0.573–1.382)
0.745 (0.587–1.536)
61–70
64 (10.46)
82 (13.40)
0.797 (0.534–1.190)
0.862 (0.512–1.163)
≥70
47 (7.68)
53 (8.66)
0.904 (0.607–1.347)
0.836 (0.477–1.421)
Duration of hypertension
Three years and below
19 (3.10)
41 (6.70)
1
1
Four years
14 (2.29)
25 (4.10)
1.216 [0.823–2.572]
1.211 [0.584–2.635]
Five years
70 (11.44)
108 (17.65)
1.276 [0.815–3.265]
1.355 [0.674–3.481]
Six years
105 (17.16)
136 (22.22)
1.241 [0.736–2.341]
1.316 [0.622–2.415]
Seven years
39 (6.37)
55 (8.99)
2.592 [2.35–6.332]
2.716 [1.632–7.082]
Class of hypertensive medications
ACIES
15 (2.45)
27 (4.41)
1
1
BBCs
20 (3.27)
24 (3.92)
2.951 [2.651–5.535]
2.974 [2.631–7.072]
CCBs
17 (2.78)
21 (3.43)
0.614 [0.143–2.639]
0.517 [0.137–2.174]
Diuretics
14 (2.29)
25 (4.08)
1.654 [0.727–3.974]
1.521 [0.689–3.454]
Diuretics + ACEIs
70 (11.44)
80 (13.07)
1.375 [0.146–3.369]
1.528 [0.636–3.158]
Diuretics + β-blocker
68 (11.11)
73 (11.93)
1.146 [0.765–2.321]
1.256 [0.674–2.117]
B-blockers + ACEIs + diuretics
56 (9.15)
53 (8.66)
1.248 [0.436–2.773]
1.210 [0.481–2.576]
Other combinations
21 (3.43)
28 (4.57)
1.431 [0.726–2.372]
1.431 [0.783–2.541]
ACEIS: angiotensin convertase inhibitors, CCBs: calcium channel blockers, BBCs: beta-blockers, CHR: crude hazard ratio, and AHR: adjusted hazard ratio, significant at 0.05 level. Female, urban residence, absence of comorbidity, systolic hypertension, one-month duration of appointment, uncontrolled BP, concordance with guidelines, presence of regimen change, monotherapy, and age between 21 and 30 were our reference variables. indicates significance at 0.01 level.
