Objective:
We investigated the prevalence of blood pressure <130/80 mmHg and studied factors associated with elevated blood pressure in hypertensive ambulatory heart failure patients.
Methods:
Records of 194 unselected consecutive heart failure patients were reviewed. Demographic and clinical data were collected. ANOVA, chi-square, and logistic regression analyses were used.
Results:
Systolic blood pressure less than 130 mmHg and diastolic blood pressure less than 80 mmHg was achieved in 52.9% of patients, in 58.4% of men and in 41.6% of women (p=0.076). Patients with diabetes (62%) were more likely to achieve optimal blood pressure (46.4% of patients without diabetes, p=0.033). Age, depressed ejection fraction, body mass index, hemoglobin, creatinine clearance, and histories of dyslipidemia, coronary artery disease, or peripheral vascular disease were not predictive of suboptimal blood pressure control.
There was no association between treatment with ACE inhibitors (52.5% of patients with optimal blood pressure vs. 47.8% of patients with suboptimal blood pressure, p=0.517), ARBs (16.8 vs. 15.6%, p=0.811), or beta-blockers (90 vs. 85.6%, p=0.336) and achieving optimal blood pressure. Patients with optimal blood pressure were more likely to have been treated with diuretics (65.3 vs. 50%, p=0.032) or aldosterone receptor antagonists (36.6 vs. 16.7%, p=0.017). Increased use of calcium-channel blockers (CCBs) (12.9 vs. 30%, p=0.003) was noted in patients with suboptimal blood pressure control.
Conclusions:
Only half of the hypertensive patients with heart failure achieved blood pressure less than 130/80 mmHg, and women were less likely than men to attain optimal blood pressure control. Optimal blood pressure control was more prevalent if the therapeutic regimen included diuretics or aldosterone receptor antagonists. Whether CCBs are used more commonly in patients with elevated blood pressure or whether CCBs are less useful for blood pressure control cannot be established.
Fixed Low-Dose Triple Combination Antihypertensive Medication vs Usual Care for Blood Pressure Control in Patients With Mild to Moderate Hypertension in Sri Lanka