[PP.16.28] LONG-TERM MANAGEMENT OF HYPERTENSION. DOES THE INITIAL GLOBAL CARDIOVASCULAR RISK HAVE AN IMPACT?

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Abstract

Objective:

To evaluate the long-term management of high blood pressure in real life through its control, its complications and the impact of global cardiovascular risk.

Design and method:

The management of one hundred twenty-two outpatients, black Africans were observed for a median of 9 years at Institute of Cardiology of Abidjan. Blood pressure control (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg) was evaluated at the initial stage and then approximately every 3 years. The global cardiovascular risk was determined according to the Framingham equation and patients were classified into three risk groups (low (<10%), medium (10 to 20%) and high (> or equal to 20%)). cardiovascular events (death or complications) were recorded. A comparison with the original cardiovascular risk level has been made from a Chi2 test. A p value <0.05 was considered statistically significant.

Results:

One hundred twenty-two patients were observed during a period of 9 years (56.6% women, mean age = 53.1 ± 10.4 years). In addition to blood pressure, the median number of associated risk factor were 2. Moderate hypertension (Grade2) were proeminantm (40.2%). The global cardiovascular risk of patients was high (20 8 ± 12.8%) with 45.9% of patients with cardiovascular risk > or equal to 20% in 10 years. The target blood pressure was achieved in 36% of patients in the first stage, 35.2% in the 2nd phase and 20.5% to the last phase. This bad blood pressure control was higher in patients at high cardiovascular risk in the 3rd phase (p < 0.0001). Twenty-three cardiovascular events occurred in 21 patients (18.9%) similar to the overall cardiovascular risk (p = 0.90). But the analysis of subgroups at risk, Framingham equation did not predict the occurrence of these events (p = 0.43)

Conclusions:

Hypertension long-term managed remains inadequately controlled. Cardiovascular risk according to the Framingham equation enabled globally predicting the occurrence of events without being able to discriminate subgroups.

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