HYPERTENSION AS A CLINICAL PRESENTATION AND A RISK FACTOR IN PATIENTS WITH PULMONARY EMBOLISM

Objective: Hypertension is increasingly recognized as a major risk factor for cardiovascular disease. Pulmonary embolism (PE) is a multifactorial disease, but little is known about the features of subjects with unprovoked PE. An isolated factor alone may not be enough, but irrelevant predictors in the past are now becoming relevant in particular conditions. The aim of this study is to characterize hypertension in patients with PE. Design and method: We conducted a descriptive study between January 2023 - December 2023 involving patients admitted in the Cardiology Department with PE. Statistical analysis was performed using Microsoft Excel and Socscistatistics Software. Results: The study cohort consisted of 78 patients ranging in age from 22 to 95 years. When analyzing the cohort, we found that 43 patients (55.12%) were male and the mean age was 68.41 years. 65.38% of patients were diagnosed with hypertension and 39.74% had associated deep vein thrombosis. The mean hospital stay was 9.85 days and the all-cause mortality was 6.41%. The most common symptoms were dyspnea (75.64%) and lower limb swelling/pain (29.48%). On admission, the mean D-dimer level was 4123.56 ng/ml and NT-proBNP level was 2549.99 pg/ml. Systolic blood pressure was greater than 140 mmHg in 34 cases. The mean ejection fraction determined by transthoracic echocardiography was 52.2%, and 80.76% of cases had preserved ejection fraction. 5 patients had atrial fibrillation and 21 patients had tachycardia on the resting electrocardiogram. Subjects with hypertension were associated with increased NT-proBNP level >300 pg/ml (p=0.0772), with dyslipidemia (p=0.0001) and with diabetes mellitus (p=0.0278). Blood pressure above 140 mmHg was more frequent in the subgroup of patients with diagnosed hypertension (p=0.0026). In patients with unprovoked thromboembolism, hypertension did not significantly increase the likelihood of occurrence (p=0.3565), but adjusting for age or increasing number of risk factors significantly predicted the risk of thromboembolism. Conclusions: The study highlights the significant association between conventional cardiovascular risk factor (in particular hypertension) and evolutions on patients with PE. Specific biomarkers, epidemiologic factors and number of risk factors can affect the outcomes and the evolution of patients.