Persistence of uncontrolled hypertension post-cardiac rehabilitation in stable coronary patients.

Journal of Human Hypertension
Thierry DenolleFlorence Revault d'Allonnes

Abstract

In stable coronary heart disease, uncontrolled risk factors are strongly associated with incident myocardial infarction. We analysed the management of hypertension in 746 stable coronary patients recruited between 2005 and 2015 in a single-centre prospective study. Risk factors and pharmacological treatments were documented prior to and immediately after cardiac rehabilitation, and 1 year later. One year post-cardiac rehabilitation, all cardiovascular risk factors were significantly better controlled with the notable exception of hypertension: blood pressure (BP) <140/90 mmHg in 60% of the total population vs 49% (N = 450) of hypertensive patients (20% or 10%, according to the ACC/AHA 2017 or ESH/ESC guidelines, respectively). Of those who had achieved normotension by the end of cardiac rehabilitation, 42% had uncontrolled hypertension again 1 year later; in addition, body weight had increased, while physical activity and antihypertensive drug use had dropped (differences between controlled or uncontrolled hypertension at 1 year post-cardiac rehabilitation, NS). Three factors were correlated with BP elevations: discontinuation of betablockade: +7.9 mmHg; age >65 years: +6.2 mmHg; diabetes mellitus: +7.6 mmHg. Only 48% hypertens...Continue Reading

References

Nov 9, 2004·The New England Journal of Medicine·Eugene BraunwaldUNKNOWN PEACE Trial Investigators
Mar 17, 2009·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Kornelia KotsevaUNKNOWN EUROASPIRE Study Group
Jun 20, 2012·Archives of Cardiovascular Diseases·Bruno PavyUNKNOWN French Society of Cardiology
Aug 21, 2013·Fundamental & Clinical Pharmacology·Jacques BlacherUNKNOWN French Society of Hypertension
Jan 21, 2017·Circulation Research·George A MensahDavid Gordon
Apr 30, 2017·Journal of the American College of Cardiology·Gilles LemesleChristophe Bauters
Jun 27, 2017·Annales de cardiologie et d'angéiologie·T DenolleF Revault d'Allonnes

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