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Incidence and risk of hypertension in patients newly treated for multiple myeloma: a retrospective cohort study

View Article: PubMed Central - PubMed

ABSTRACT

Background: Hypertension is commonly reported in multiple myeloma (MM) patients and may be associated with older age, disease-related complications and consequences of MM treatments. This study evaluated the incidence rates of and risk factors for hypertension and malignant hypertension in newly-treated MM patients in the United States.

Methods: Newly-treated adult MM patients were identified from Truven MarketScan claims database from 1/1/05 to 3/31/14. Inclusion criteria were new diagnosis of MM with start of MM treatment, ≥12 months continuous enrollment prior to diagnosis, ≥30 days of continuous enrollment following initial diagnosis, and prescription drug coverage. Non-MM patients were matched for age (within +/− 5 years), sex and distribution of index dates to MM patients. Baseline cardiovascular (CV) comorbidities, incidence rate of hypertension and malignant hypertension in the follow-up period, and risk of hypertension and malignant hypertension based on existing baseline CV comorbidities were evaluated.

Results: A total of 7895 MM patients (38% with hypertension history) and 23,685 non-MM patients (24% with hypertension history) were included in the study. Twenty-two percent of MM patients versus 3% of non-MM patients had baseline renal failure. A higher percentage of MM versus non-MM patients had baseline hypertension in combination with renal failure, congestive heart failure or both. The incidence rate of hypertension in MM and non-MM patients was 260 and 178 per 1000 person-years, respectively. There was a 30% increase in the risk of hypertension for MM versus non-MM patients: hazard ratio (HR) 1.30 (95% confidence interval [CI] 1.22, 1.37). In MM patients with a history of hypertension, the risk of malignant hypertension was significantly increased with the following comorbid conditions: cardiomyopathy, HR 2.79 (95% CI 1.20, 6.48); renal failure, HR 2.13 (95% CI 1.36, 3.34); and diabetes mellitus, HR 1.59 (95% CI 1.05, 2.39).

Conclusions: This study confirms that the incidence of hypertension and malignant hypertension is significantly higher in newly-treated MM versus non-MM patients. Hypertension is a risk factor for MM patients developing malignant hypertension. Management of CV comorbidities in MM patients is important based on the increased risk of hypertension and malignant hypertension among patients with these comorbidities.

Electronic supplementary material: The online version of this article (doi:10.1186/s12885-016-2955-0) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus

Selection of MM patient cohort. MM drugs identified on prescription claims. CE, continuous enrollment; ICD-9, international classification of diseases, ninth revision; MM, multiple myeloma
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Fig1: Selection of MM patient cohort. MM drugs identified on prescription claims. CE, continuous enrollment; ICD-9, international classification of diseases, ninth revision; MM, multiple myeloma

Mentions: A total of 49,565 patients with a MM diagnosis code claim were identified between January 1, 2005 and March 31, 2014 (Fig. 1). Based on inclusion and exclusion criteria, 7895 patients were included in the MM patient cohort for study analysis. A total of 23,685 patients were identified and matched to the MM patients and comprised the non-MM patient cohort for study analysis. The MM and non-MM patients were generally well-matched on distribution of index dates (Table 1).Fig. 1


Incidence and risk of hypertension in patients newly treated for multiple myeloma: a retrospective cohort study
Selection of MM patient cohort. MM drugs identified on prescription claims. CE, continuous enrollment; ICD-9, international classification of diseases, ninth revision; MM, multiple myeloma
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5120425&req=5

Fig1: Selection of MM patient cohort. MM drugs identified on prescription claims. CE, continuous enrollment; ICD-9, international classification of diseases, ninth revision; MM, multiple myeloma
Mentions: A total of 49,565 patients with a MM diagnosis code claim were identified between January 1, 2005 and March 31, 2014 (Fig. 1). Based on inclusion and exclusion criteria, 7895 patients were included in the MM patient cohort for study analysis. A total of 23,685 patients were identified and matched to the MM patients and comprised the non-MM patient cohort for study analysis. The MM and non-MM patients were generally well-matched on distribution of index dates (Table 1).Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Hypertension is commonly reported in multiple myeloma (MM) patients and may be associated with older age, disease-related complications and consequences of MM treatments. This study evaluated the incidence rates of and risk factors for hypertension and malignant hypertension in newly-treated MM patients in the United States.

Methods: Newly-treated adult MM patients were identified from Truven MarketScan claims database from 1/1/05 to 3/31/14. Inclusion criteria were new diagnosis of MM with start of MM treatment, ≥12 months continuous enrollment prior to diagnosis, ≥30 days of continuous enrollment following initial diagnosis, and prescription drug coverage. Non-MM patients were matched for age (within +/− 5 years), sex and distribution of index dates to MM patients. Baseline cardiovascular (CV) comorbidities, incidence rate of hypertension and malignant hypertension in the follow-up period, and risk of hypertension and malignant hypertension based on existing baseline CV comorbidities were evaluated.

Results: A total of 7895 MM patients (38% with hypertension history) and 23,685 non-MM patients (24% with hypertension history) were included in the study. Twenty-two percent of MM patients versus 3% of non-MM patients had baseline renal failure. A higher percentage of MM versus non-MM patients had baseline hypertension in combination with renal failure, congestive heart failure or both. The incidence rate of hypertension in MM and non-MM patients was 260 and 178 per 1000 person-years, respectively. There was a 30% increase in the risk of hypertension for MM versus non-MM patients: hazard ratio (HR) 1.30 (95% confidence interval [CI] 1.22, 1.37). In MM patients with a history of hypertension, the risk of malignant hypertension was significantly increased with the following comorbid conditions: cardiomyopathy, HR 2.79 (95% CI 1.20, 6.48); renal failure, HR 2.13 (95% CI 1.36, 3.34); and diabetes mellitus, HR 1.59 (95% CI 1.05, 2.39).

Conclusions: This study confirms that the incidence of hypertension and malignant hypertension is significantly higher in newly-treated MM versus non-MM patients. Hypertension is a risk factor for MM patients developing malignant hypertension. Management of CV comorbidities in MM patients is important based on the increased risk of hypertension and malignant hypertension among patients with these comorbidities.

Electronic supplementary material: The online version of this article (doi:10.1186/s12885-016-2955-0) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus