Background No studies have been performed so far in Poland assessing the effectiveness of blood pressure control in hypertensive patients with coronary heart disease (CHD). The aim of the Cracovian Program for Secondary Prevention of Ischaemic Heart Disease was to monitor the actions undertaken in secondary prevention of CHD. The aim of this paper is to evaluate the effectiveness of blood pressure control in patients with CHD.
Material and methods Study population included 536 patients (aged Ł 70 years) with a diagnosis of acute myocardial infarction, unstable angina, percutaneous coronary angioplasty or qualification for a coronary-aortic bypass surgery hospitalised in Krakow in six cardiology units: three in university hospital and three in community hospitals. Control visit was performed 6–18 months after the hospitalisation.
Results Mean blood pressure in the whole study population during control visit 6–18 months after the hospitalisation was 137,9 (± 21,4) mm Hg and 83,4 (± 11,0) for systolic and diastolic BP, respectively, while elevated blood pressure (ł 140/90 mm Hg) was observed in 46,2% of subjects. Hypertension was present in 67,0% of patients. In the hypertensive group 30,9% of patients had BP below 140/90 mm Hg, and 91,4% received antihypertensive drugs. In the latter subgroup in 33,9% of patients BP remained below 140/90. In patients aged 60 years or more worse control of BP was observed when compared with younger subjects (BP ł 140/90 in 76,5% and 63,5% respectively, p < 0,05). Sex, duration of education, CHD risk factors, history of myocardial infarction, cardiac revascularisation and the site of post-hospital care did not influence significantly the prevalence of elevated BP values. In 20% of the hypertensive patients hypertension was not diagnosed during hospitalisation qualifying for the study.
Conclusion The efficacy of antihypertensive treatment in the secondary prevention of coronary heart disease is unsatisfactory.