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Optimal blood pressure control after coronary events: the challenge remains
Vestre Viken Trust, Norway;Univ Oslo, Norway.
Vestfold Hosp Trust, Norway.
Vestfold Hosp Trust, Norway.
Univ Oslo, Norway.
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2017 (English)In: Journal of the American Society of Hypertension : JASH, ISSN 1933-1711, E-ISSN 1878-7436, Vol. 11, no 12, p. 823-830Article in journal (Refereed) Published
Abstract [en]

We identified sociodemographic, medical, and psychosocial factors associated with unfavorable blood pressure (BP) control in 1012 patients, hospitalized with myocardial infarction and/or a coronary revascularization procedure. This cross-sectional study collected data from hospital records, a comprehensive self-report questionnaire, clinical examination, and blood samples after 2-36 (mean 17) months follow-up. Forty-six percent had unfavorable BP control (>= 140/90 [80 in diabetics] mm Hg) at follow-up. Low socioeconomic status and psychosocial factors did not predict unfavorable BP control. Patients with unfavorable BP used on average 1.9 (standard deviation 1.1) BP-lowering drugs at hospital discharge, and the proportion of patients treated with angiotensin inhibitors and beta-blockers decreased significantly (P < .001) from discharge to follow-up. Diabetes (odds ratio [OR] 2.4), higher body mass index (OR 1.05 per 1.0 kg/m(2)), and older age (OR 1.04 per year) were significantly associated with unfavorable BP control in adjusted analyses. Only age (standardized beta [beta] 0.24) and body mass index (beta 0.07) were associated with systolic BP in linear analyses. We conclude that BP control was insufficient after coronary events and associated with obesity and diabetes. Prescription of BP-lowering drugs in hypertensive patients seems suboptimal. Overweight and intensified drug treatment thus emerge as the major factors to target to improve BP control. (C) 2017 American Society of Hypertension. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 11, no 12, p. 823-830
Keywords [en]
Antihypertensive treatment, medical factors, psychosocial factors, secondary prevention
National Category
Nursing Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-69796DOI: 10.1016/j.jash.2017.10.007ISI: 000418878300006PubMedID: 29128603OAI: oai:DiVA.org:lnu-69796DiVA, id: diva2:1173539
Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-01-12Bibliographically approved

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Perk, Joep

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