BLOOD PRESSURE AND RELATED RISK FACTORS CONTROL IN PATIENTS AFTER CORONARY REVASCULARIZATION - WE CAN DO IT BETTER: PP.26.64

Abstract

Objective: To study blood pressure (BP) values and treatment and related risk factors control in patients with coronary heart disease after revascularization with PCI and/or CABG. Design: An observation study on 190 patients treated with PCI and/or CABG for unstable angina or/and non elevation myocardial infarction aged 18 years and older in the period 1999 C 2001 with two examinations, that took place in 2002–2003 and 2007. Methods: Blood pressure was measured with a Mercury sphygmomanometer and by automated electronic device 24-hours at home and clinical history was recorded during the ambulatory visit. Fasting blood tests for lipids and plasma glucose were examined and morning urine was tested for albumin. Uncontrolled BP was defined as BP≥140/90 mmHg at the office (≥135/85 mmHg mean daytime at home) in patients with normal value of plasma glucose and as BP≥130/80 mmHg (resp. ≥125/75 mmHg) in patients with elevated levels of fasting plasma glucose. Results: Well controlled BP by the first examination was found in 109 patients (N = 190, 57.4%) and in 67 patients (N = 134, 50%) by the second examination respectively according to office BP measurements and according to ambulatory BP measurements respectively in 92 patients (N = 190, 48.4%) and in 79 patients (N = 134, 59%). Blood pressure lowering medication was registered in 160 patients (84.2%, N = 190) and in 116 patients (86.6%, N = 134) by the first and by the second examination respectively. Hypertensives did not achieve better BP regulation despite more medicines. Elder patients were more insufficiently treated. Conclusion: Very high risk patients with established IHD and treated with OCI or/and CABG are not controlled sufficiently and not medically target treated regarding modifycible risk factors. They should be followed by cardiologists in out patient specialized clinics. Ambulatory BP monitoring should be routinely used to achieve normal BP levels.