PS 14-12 CLINICAL SIGNIFICANCE OF AMBULATORY BLOOD PRESSURE MONITORING IN PATIENTS WITH CARDIOVASCULAR DISEASES WHO UNDERWENT CARDIAC REHABILITATION. (September 2016)

• Record Type: Journal Article
• Authors: Inoue, Minako; Fujishima, Shinichiro; Tomita, Yusuke; Aoyagi, Ikumi; Kaseda, Shigeru; Koga, Tokushi; Tsuchihashi, Takuya
• Is Part Of: Journal of hypertension. Volume 34:(2016) Supplement 1
• Publication Date: 2016-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000501135.04444.0f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Though optimal blood pressure (BP) control is crucial in the treatment of patients with cardiovascular diseases (CVDs), the usefulness of ambulatory BP monitoring (ABPM) in cardiac rehabilitation remains unclear. The aim of the present study was to investigate the association between BP evaluated by ABPM and adverse symptoms or events in patients who underwent cardiac rehabilitation. Design and Method: Sixty patients (mean age; 80 ± 10 years, mean ± s.d. female; 51.7%, heart failure as a cause of index hospitalization, 72%) who could walk by themselves were studied BP levels, circadian rhythm using ABPM before discharge, symptoms due to hypotension from clinical records during admission, and they were followed up until a year after. Results: Among the subjects, mean 24-hour BP was 128 ± 18/72 ± 8 mmHg on 2.6 ± 1.3 anti-hypertensive drugs, and the majority of them represented non-dipper (48%) or riser (33%) pattern. When the subjects were categorized into the low, medium, and high BP group based on the tertiles of the mean 24-hour systolic BP (SBP), the prevalence of hypotensive symptoms were 5%, 5%, and 10% respectively. During the follow-up period (median, 375 days), 23 composite adverse events occurred. The prevalence of the composite events was highest in the high BP group, and there was a significant difference among the event-free survival curves of these three groups (p < 0.01) by Kaplan–Meier method and log-rank test. The adjusted relative hazard ratio of mean 24-hour SBP for the composite events was 9.32 (95%CI; 1.13–81.2, p < 0.01) with a 1 s.d. increment by Cox proportional hazard model. There was no significant difference in the prevalence of hypotensive symptoms or the composite adverse events among circadian rhythms. Conclusions: These results suggest that mean value of 24-hour BP was associated with the adverse events in patients who underwent rehabilitation for CVDs. There were no significant relations among BP levels, circadian rhythms, and hypotensive symptoms.