PP.03.22

Abstract

Objective: Blood pressure variability, both short- and long-term, is a novel important prognostic factor. Seasonal variation of cardio-vascular morbidity and mortality is observed worldwide and the major determinant of this phenomenon is the seasonal changes in blood pressure. To assess the knowledge and understanding of the presence of blood pressure variation within the year and how it affects the antihypertensive treatment. Design and method: We sent questionnaires to 305 patients, 91% with arterial hypertension, and 174 physicians in various living settings. Besides the demographic characteristics, we asked them whether they were acquainted with the problem seasonal variation of blood pressure and whether they accepted it. There were questions how this phenomenon affected their treatment strategy. Results: The patients were at a mean age 57.3 ± 12.57 years (18–89 years), 42% were males and 74% were medically treated, while the physicians were mainly cardiologists (62%), at a mean age 50.80 ± 8.14 (27–73) years and with on average 25 years of professional experience. The vast majority of patients (62%) and of physicians (94%) accepted the seasonal phenomenon. The same number of patients (163 or 63%) and almost all physicians (167 or 96%) has measured lower blood pressure values during summer. This understanding lead to change in the therapeutic behavior. Only 19% did not change their treatment schemes, while 13.4% reduced or increased medications on their own. Their treating physicians changed the patients’ therapy according to the season regularly in 48% of the cases and sometimes in 41%. They reported that 26 % of their patients changed their antihypertensive therapy regularly and another 66% did it from time to time. More than two thirds of the physicians (120 or 69%) admitted that changes in guidelines are needed. Conclusions: The majority of hypertensive patients and their treating physicians accept seasonal variation of blood pressure. Moreover, a large number of patients change their treatment schemes, either alone or advised by healthcare professionals. Cardiologists in Bulgaria modify the antihypertensive treatment according to the season and recommend changes in current guidelines.