The impact of the arterial hypertension on rotator cuff tear

Introduction Aetiology of rotator cuff tear is multifactorial. Causes responsible for the tear include tendon hypovascularity and cardiovascular diseases. Aim To establish if hypertension increases risk of occurrence of rotator cuff tear and influences its size. Methods We studied 408 consecutive patients mean age 59 y.o who underwent arthroscopic rotator cuff repair. Tear size was determined during surgery. Patients were divided into two groups based on presence/absence of hypertension. We applied a logistic regression model to investigate if hypertension affects the risk of cuff tear. A multinomial logistic regression model was applied to explore association between hypertension and tear size. We used the ANCOVA method to determine if duration of hypertension influences the severity of tear; finally, we compared mean duration of anti-hypertensive therapy in small, large and massive tear patients. All analyses were adjusted for age and gender. Results Hypertension was associated with a two-fold higher risk of tear occurrence (OR=2.05,95%CI:1.41-2.98). While no association was detected between hypertension and probability of small tear(OR=0.63, 95%CI: 0.33-1.19), hypertensive subjects were twice more likely to experience a large tear(OR=2.09,95%CI:1.39-3.16) and four times more likely to experience a massive tear(OR=4.30,95%CI:2.44-7.58) as opposed to normotensive subjects. Mean duration of anti-hypertensive therapy significantly increased from small tear(1.08 years) to large tear(3.20 years) to massive tear(6.34 years) patients(ANCOVA:F(2,403)=16.357, p=1.48×10-7). Conclusion Hypertension is more prevalent in patients with rotator cuff tear. We found a significantly higher mean duration of therapy for patients with a more severe tear. Hypertension is a significant risk factor for the occurrence and severity of rotator cuff tears.