Abstract P298: The Impact of JNC VII Recommendations for Controlling Blood Pressure in a Heart Failure Disease Management Program
Background: A significant correlation between hypertension (HTN) and long-term risk for heart failure (HF) exists. The aim of this study was (i) to assess what percent of patients enrolled in a heart failure disease management program (HFDMP) reach the JNC VII target goals for blood pressure control; (ii) to assess if there is a disparity in HTN control by race or ethnicity; (iii) and to assess the impact of reaching JNC VII targets for blood pressure control on survival. Methods: Patients with an ejection fraction ≤40% were enrolled into HFDMPs and screened for HTN, defined as blood pressure (BP) ≥ 130/80. Patients were titrated to beta blocker therapy and ace inhibitor therapy following the ACC/AHA HF guidelines. Final BP was measured after one year. Results: Mean baseline systolic BP (SBP) (N = 648) was 149.9 mmHg and mean baseline diastolic BP (DBP) was 90.5 mmHg. At one year, mean SBP decreased to 138.0 mmHg, DBP to 81.8 mmHg. There was no significant increase in survival for patients with BP ≤130 and ≤80 versus patients with HTN. There was a significant disparity in BP control in Blacks and Hispanics compared to whites (p<0.001) Conclusion: Disease management programs are an effective way to reduce BP in hypertensive patients, as well as keeping normotensive patients within JNC VII guidelines however health disparities persisted by race and ethnicity. Mean SBP and DBP of cohort at baseline Vs. 12 Month Follow up Blood pressure ≤ 130/80 mmHg Baseline Visit Last Visit P-Value SBP,m sd 110.9 (12.6%) 120.9 (22.2%) <0.001 DBP , m sd 67.1 (8.6%) 72.4 (13.7%) <0.001 Blood pressure > 130/80 mmHg Baseline Visit Last Visit P-Value SBP , m sd 149.9 (21.4%) 138.0 (24.6%) <0.001 DBP , m sd 90.5 (16.3%) 81.8 (16.8%) <0.001