Cardiovascular risk after liver transplantation
Cardiovascular risk after liver transplantation
Using data from patient records, I assessed the prevalence of risk factors for cardiovascular disease after liver transplant and compared these to a non-transplant population. The data was to examine the effect of switching immunosuppression from cyclosporin to tacrolimus upon cardiovascular risk. Clinical trials involving liver transplant recipients have examined the role of endothelin, renin-aldosterone and arterial stiffness in the development of hypertension, the efficacy of different antihypertensive drugs and the value of brain natriuretic peptide (BNP) as a potential screening tool for left ventricular impairment in hypertensive patients.
The predicted 10 - year probability of coronary heart disease (CHD) increased after liver transplant and was higher than a matched non-transplant population. Hypertension and hypercholesterolaemia were the most common risk factors for CHD. Tacrolimus was associated with a reduced prevalence of cardiovascular risk factors compared with cyclosporin and switching to tacrolimus can reduce blood pressure, weight and serum cholesterol. Increases in arterial stiffness and plasma endothelium-1 were implicated in the development of hypertension during the first 6 months. Amlodipine was optimum first line treatment of hypertension, with Iisinopril being superior to bisoprolol was second-line treatment. BNP levels were raised in transplant recipients, particularly those with hypertension. Hyperuricaemia is common after liver transplantation and is associated with an increased predicted risk of CHD.
CHD risk rises after liver transplantation. It is likely that this will lead to an increase in post-transplant morbidity and mortality form cardiovascular disease, but this is not apparent by 5 years. Management of hypertension, hypercholesterolaemia and attention to weight gain after transplant are important to reduce the burden of post-transplant cardiovascular disease.
University of Southampton
Neal, David A. J
3fd3389a-c87e-4ce9-a006-cdacd9139569
2003
Neal, David A. J
3fd3389a-c87e-4ce9-a006-cdacd9139569
Neal, David A. J
(2003)
Cardiovascular risk after liver transplantation.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
Using data from patient records, I assessed the prevalence of risk factors for cardiovascular disease after liver transplant and compared these to a non-transplant population. The data was to examine the effect of switching immunosuppression from cyclosporin to tacrolimus upon cardiovascular risk. Clinical trials involving liver transplant recipients have examined the role of endothelin, renin-aldosterone and arterial stiffness in the development of hypertension, the efficacy of different antihypertensive drugs and the value of brain natriuretic peptide (BNP) as a potential screening tool for left ventricular impairment in hypertensive patients.
The predicted 10 - year probability of coronary heart disease (CHD) increased after liver transplant and was higher than a matched non-transplant population. Hypertension and hypercholesterolaemia were the most common risk factors for CHD. Tacrolimus was associated with a reduced prevalence of cardiovascular risk factors compared with cyclosporin and switching to tacrolimus can reduce blood pressure, weight and serum cholesterol. Increases in arterial stiffness and plasma endothelium-1 were implicated in the development of hypertension during the first 6 months. Amlodipine was optimum first line treatment of hypertension, with Iisinopril being superior to bisoprolol was second-line treatment. BNP levels were raised in transplant recipients, particularly those with hypertension. Hyperuricaemia is common after liver transplantation and is associated with an increased predicted risk of CHD.
CHD risk rises after liver transplantation. It is likely that this will lead to an increase in post-transplant morbidity and mortality form cardiovascular disease, but this is not apparent by 5 years. Management of hypertension, hypercholesterolaemia and attention to weight gain after transplant are important to reduce the burden of post-transplant cardiovascular disease.
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Published date: 2003
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Local EPrints ID: 465607
URI: http://eprints.soton.ac.uk/id/eprint/465607
PURE UUID: 13584815-2f37-43d2-ac10-f346573ac6b9
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Date deposited: 05 Jul 2022 02:00
Last modified: 16 Mar 2024 20:16
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Author:
David A. J Neal
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