Control of hypertension in coronary heart disease

Area of Science:

• Cardiology
• Hypertension Research
• Preventive Medicine

Background:

• Investigates out-of-office hypertension control in coronary heart disease (CHD) patients using 24-h ambulatory blood pressure monitoring (ABPM).
• Utilizes data from the Spanish Society of Hypertension ABPM Registry, encompassing a large network of primary care physicians.
• Compares out-of-office BP control with traditional in-office measurements in treated essential hypertensive patients with CHD.

Discussion:

• Out-of-office hypertension control (46.4%) significantly exceeded in-office control (28.7%) in 2434 treated CHD patients.
• Identified 'office resistance' in 25.2% of patients, characterized by normal ambulatory BP but elevated office BP despite treatment.
• Highlights the discrepancy between office and ambulatory BP measurements in assessing hypertension control.

Key Insights:

• Ambulatory blood pressure monitoring (ABPM) provides a more accurate assessment of hypertension control in CHD patients compared to office BP.
• A substantial proportion of patients exhibit 'office resistance,' masking true BP control status.
• Current hypertension management strategies may overestimate control based solely on office readings.

Outlook:

• Further efforts are required to optimize BP control in CHD patients.
• Physicians can be reassured by potentially better BP control than previously estimated from office data.
• Recommends the integration of ABPM for a more comprehensive understanding of hypertension management in CHD.