Abstract 9451: Association Between Hypertension and Incident Infective Endocarditis

Abstract

Introduction: This study aimed to evaluate the association of hypertension with incident infective endocarditis (IE) by investigating the incidence of IE according to blood pressure levels using the National Health Insurance Service database. Hypothesis: Considering the recent rise in the incidence of IE and the fact that little research has been conducted on the relationship between blood pressure levels and IE incidence, we hypothesized that hypertension may serve as a risk factor for incident IE. Methods: The data of 4080331 individuals linked to the health screening database in 2009 were retrieved (males, 55.08%; mean age 47.12 ± 14.13 years). From 2009 to 2018, the risk factors for the first episode of IE were investigated. Hypertension was categorized into normotension, prehypertension, hypertension, and hypertension with medication. The Cox proportional hazard model assessed the effect of blood pressure level during the health screening exam on incident IE. Results: During the 9-year follow-up, 812 (0.02%) participants were diagnosed with IE. The incidence rates of IE in the normotension, prehypertension, hypertension, and hypertension with medication groups were 0.9, 1.4, 2.6, and 6.0 per 100,000 person-years, respectively. Those with prehypertension, hypertension, and hypertension with medication were correlated with an increased risk of IE in a dose-response manner compared with the normotension group (hazard ratio, 1.33 [95% CI, 1.06-1.68]; hazard ratio, 1.98 [1.48-2.66]; hazard ratio, 2.56 [2.02-3.24], respectively, all P<0.001). Conclusions: In a large national cohort study with an average follow-up of 9-years, increased blood pressure was identified as a risk factor for incident IE in a dose-dependent manner. Hypertension increases the public health care burden by acting as a risk factor for rare infective heart diseases.