Abstract P157: Challenging Blood Pressure Control In Heart Failure Patients And Related Factors

Background: The 2017 ACC/AHA hypertension guidelines were released, and it specified blood pressure (BP) control goals in diverse situation. We will determine how the guideline can affect heart failure blood pressure control and risk factors for the control. There is not enough data how BP is controlled and what risk factors are related to controlled BP in heart failure patients according to the 2017 hypertension guideline. Method: 3276 heart failure patients who visited a community hospital for any medical reason were included and analyzed retrospectively from November 2017 to December 2018. Control of blood pressure will be defined based on the guidelines which show that heart failure patients’ blood pressure target is less than 130 /80 mmHg. ACE inhibitors/Aldosterone receptor blocker, diuretics(HCTZ, Furosemide, Butamex), Spironolactone, calcium channel blocker, and Angiotensin Receptor Neprilysin Inhibitor( Entresto), comorbidities(diabetes, chronic kidney disease, hyperlipidemia), age, gender, and ethnicities were collected and used for multi-variable adjusted logistic regression model. Results: 29.6% (555/1873) male patients were controlled based on the guidelines, on the contrary, 34.3%(482/1403) female patients revealed blood pressure control.The African american population’s BP was the most uncontrolled among all ethnicities. Multivariable logistic regression analysis was performed. Age of less than 65 years old [Odds ratio (OR): 2.81,95% Confidence Interval(CI): 2.41-3.26] was associated with controlled blood pressure. DM [OR: 0.71,95% CI: 0.61-0.82], beta-blocker [OR: 0.79,95% CI: 0.64-0.96] and LDL of more than 100mg/dl [OR: 0.57,95%, CI: 0.45-0.71] were noted to have significantly the uncontrolled BP. Conclusion: It appears about only one third of heart failure patients may be having their BP controlled based on 2017 ACC/AHA guideline. Beta-blocker were associated with uncontrolled blood pressure, which might suggest their dose of beta-blocker was not maximized for heart failure patients’ care. Clinicians may need to consider to try the higher dose if patients are tolerating. Elderly heart failure patients with DM or high LDL level (>100mg/dl)may need strict blood pressure control by better management of DM and LDL.

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Abstract 122: Attainment of Optimal Blood Pressure in Hypertensive Ambulatory Heart Failure Patients

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.9.suppl_2.122 ◽

2016 ◽

Vol 9 (suppl_2) ◽

Author(s):

Yana Piatetsky ◽

Matthew Scheidler ◽

Rachel Garcia ◽

Mikhail Torosoff

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Receptor Antagonists ◽

Heart Failure Patients ◽

Aldosterone Receptor ◽

Optimal Blood Pressure

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.

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Risk factors of uncontrolled hypertension in urban slums of Central India : A Community health worker based two-year follow up

10.1101/2021.02.02.21251036 ◽

2021 ◽

Author(s):

Abhijit P Pakhare ◽

Anuja Lahiri ◽

Neelesh Shrivastava ◽

N Subba Krishna ◽

Ankur Joshi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Diseases ◽

Blood Pressure Control ◽

Pressure Control ◽

Urban Slum ◽

Primary Care Providers ◽

Uncontrolled Hypertension ◽

Optimal Blood Pressure

AbstractBackgroundHypertension is a leading cause of cardiovascular diseases its control is poor. There exists heterogeneity in levels of blood-pressure control among various population sub-groups. Present study conducted in framework of National Program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS) in India, aims to estimate proportion of optimal blood pressure control and identify potential risk factors pertaining uncontrolled hypertension consequent to initial screening.MethodsWe conceived a cohort of individuals with hypertension confirmed in a baseline screening in sixteen urban slum clusters of Bhopal (2017-2018). Sixteen Accredited Social Health Activists (ASHAs) were trained from within these urban slum communities. Individuals with hypertension were linked to primary care providers and followed-up for next two years. Obtaining optimal blood-pressure control (defined as SBP< 140 and DBP<90 mm of Hg) was a key outcome. Role of baseline anthropometric, and CVD risk factors was evaluated as predictors of blood-pressure control on univariate and multivariate analysis.ResultsOf a total of 6174 individuals, 1571 (25.4%) had hypertension, of which 813 were previously known and 758 were newly detected during baseline survey. Two year follow up was completed for 1177 (74.9%). Blood-pressure was optimally controlled in 301 (26%) at baseline, and in 442 (38%) individuals at two years (absolute increase of 12%; 95% CI 10.2-13.9). Older age, physical-inactivity, higher BMI and newly diagnosed hypertension were significantly associated with uncontrolled blood-pressure.ConclusionsIn the current study we found about six of every ten individuals with hypertension were on-treatment, and about four were optimally controlled. These findings provide a benchmark for NPCDCS, in terms of achievable goals within short periods of follow-up.

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Late Eating and Blood Pressure Control and Cardiometabolic Risk Factors Among Hypertensive Adults: Results from the Korea National Health and Nutrition Examination Survey 2010–2018

Epidemiology and Health ◽

10.4178/epih.e2021101 ◽

2021 ◽

pp. e2021101

Author(s):

Jee-Seon Shim ◽

Hyeon Chang Kim

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Blood Pressure Control ◽

National Health ◽

Cardiometabolic Risk ◽

Pressure Control ◽

Cardiometabolic Risk Factors ◽

Nutrition Examination Survey ◽

Health And Nutrition

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Blood pressure control in heart failure: Is everything black and white?

Journal of Clinical Hypertension ◽

10.1111/jch.13633 ◽

2019 ◽

Vol 21 (8) ◽

pp. 1132-1134

Author(s):

Evgeny Belyavskiy ◽

Elisabeth Pieske‐Kraigher ◽

Marijana Tadic

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Black And White

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Propranolol — B.P. (‘Inderal’) and Hydrochlorothiazide Combination in Hypertension

Journal of International Medical Research ◽

10.1177/030006057300100704 ◽

1973 ◽

Vol 1 (7) ◽

pp. 616-619 ◽

Cited By ~ 1

Author(s):

P D Nigam ◽

R Ravishankar ◽

K A Ramachandren ◽

P C Sikand

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Congestive Heart Failure ◽

Side Effects ◽

Blood Pressure Control ◽

Postural Hypotension ◽

Moderate Hypertension ◽

Pressure Control

Twenty patients with mild and moderate hypertension were treated with varying doses of propranolol along with hydrochlorothiazide 25 mg daily. In eighteen patients ( 90%) the blood pressure control was good. Bronchospasm, congestive heart failure, significant postural hypotension and other bothersome side-effects were not observed. Propranolol has the merit of causing a slow reduction in blood pressure without troublesome side-effects.

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