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Chronic HCV linked to hypertension, congestive heart failure
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Patients with chronic hepatitis C are more likely to have hypertension, in addition to insulin resistance and diabetes, and also are at elevated risk for congestive heart failure, according to recent results.
Researchers evaluated data from 19,741 participants in the National Health and Nutrition Examination Survey between 1999 and 2010. The cohort included 173 patients with chronic HCV, with the remaining 19,568 classified as controls.
Participants with chronic HCV were significantly more likely than controls to be male (66.6% of cases vs. 46.1%; P=.0001), aged 45 to 55 years (41.9% vs. 20.4%; P=.0001) and African-American (23.5% vs. 10.5%; P<.0001). Those with HCV also were more likely to have hypertension (40.1% vs. 28.9%; P=.0201), greater insulin resistance (IR) (44.1% vs. 31.1%; P=.0301), and a history of tobacco use (76.2% vs. 29.9%; P<.0001).
When participants were divided according to age (younger than 65 years or 65 years and older), congestive heart failure was found to be more common among younger patients with HCV compared with controls (3.84% ± 1.50% vs. 0.89% ± 0.08%; P=.0467), but not among older patients. No associations were observed between HCV and cardiovascular disease when the cohort was stratified based on smoking status.
Advanced age, obesity and smoking were predictive of cardiovascular disease development, including congestive heart failure, ischemic heart disease and stroke (P<.05 for all). Multivariate analysis indicated independent associations between chronic HCV and IR (OR=2.06; 95% CI, 1.19-3.57), hypertension (OR=2.06; 95% CI, 1.30-3.24) and diabetes (DM) (OR=2.31; 95% CI, 1.18-4.54). Investigators also observed an association between chronic HCV and congestive heart failure (OR=2.49; 95% CI, 1.04-5.96), but not stroke or ischemic heart disease.
“Our study shows that [chronic HCV] is independently associated with three important metabolic conditions: IR, DM and hypertension,” the researchers wrote. “The association of HCV with hypertension is a novel finding. … All of these findings emphasize the importance of assessing the true impact of HCV, not only for its hepatic complications, but also for its extra-hepatic manifestations.”