ARTERIAL HYPERTENSION AS A CLINICAL PROGNOSTIC MARKER IN PATIENTS WITH MULTIPLE MYELOMA

Objective: Arterial hypertension (AH) is a well-described condition with significant cardiovascular risk and mortality, particularly when uncontrolled. Multiple myeloma (MM), the second most common hematologic malignancy, affects plasma cells, with established prognostic factors typically requiring laboratory and genetic studies. However, the prognostic role of AH on survival at the initial haematology outpatient clinic (HOC) visit before these studies are done is less defined. Design and method: We conducted a retrospective analysis of adult patients newly diagnosed with MM at University Medical Centre Maribor between 2015 and 2020, monitored at the HOC. Baseline clinical parameters and comorbidities were documented at diagnosis. Blood pressure (BP) was measured during the first HOC visit post-diagnosis. Statistical analysis was performed using SPSS, with significance set at p<0.05. Results: The study included 58 patients (51.7% female, mean age 69.3±11.7 years). Comorbidities included AH (53.5%), chronic kidney disease (CKD) (46.5%), diabetes mellitus (23.3%), heart failure (HF) (23.3%), and atrial fibrillation (14.0%). The mean body mass index (BMI) was 27.2±5.0 kg/m2. No difference was found in office BP between patients with and without AH. During an average follow-up of 758±513 days, 67.2% of patients died. Deceased patients showed a higher prevalence of HF (35.9% vs. 5.2%, p=0.012) and CKD (64.1% vs. 26.3%, p=0.011). Kaplan-Meier survival analysis revealed worse mortality for patients with AH (Log Rank 10.727, p=0.001). Cox regression confirmed AH as an independent prognostic factor alongside HF and BMI after adjusting for age, sex, performance status, and CKD (p=0.006).Conclusions: The presence of AH at the first HOC visit post MM diagnosis was associated with an independently higher risk of mortality, regardless of office BP. This underscores the importance of more intensive follow-up and tailored MM treatment for patients with AH, especially given the potential hypertensive effects of certain proteasome inhibitors.