Hypertension a risk factor for infective endocarditis

Elevated blood pressure levels appear to contribute to a dose-dependent increase in the risk of developing infective endocarditis, as shown in a study.

The study examined the potential relationship between hypertension and incident infective endocarditis (IE) by using the National Health Insurance Service database. They identified 4,080,331 individuals linked to the health screening database (mean age 47.12 years, 55.08 percent men).

Blood pressure level was categorized as normotension, prehypertension, hypertension, and hypertension with medication.

Over a follow-up of 9 years, 812 (0.02 percent) participants were diagnosed with infective endocarditis. The incidence rates of infective endocarditis increased commensurate with blood pressure levels, as follows: 0.9 per 100,000 person-years in the normotension group, 1.4 per 100,000 person-years in the prehypertension group, 2.6 per 100,000 person-years in the hypertension group, and 6.0 per 100,000 person-years in the hypertension-with-medication group.

Cox proportional hazards analysis confirmed a dose-response association between hypertension and infective endocarditis. Compared with normotension, prehypertension conferred a 33-percent risk increase (hazard ratio [HR], 1.33, 95 percent confidence interval [CI], 1.06–1.68), hypertension a 98-percent risk increase (HR, 1.98, 95 percent CI, 1.48–2.66), and hypertension with medication a 156-percent risk increase (HR, 2.56, 95 percent CI, 2.02–3.24; p<0.001 for all).

The present data indicate that hypertension can increase the public healthcare burden by acting as a risk factor for rare infective heart diseases.