Dynamics of Hypertension Control in an Acs Hospitalized Cohort Followed-Up at 6 Months

Objective: Atherosclerosis morbi-mortality in Europe remains high, despite new guidelines for management of CV risk factors and overt ischemic heart disease. Lack of control of CV risk factors is prevalent in central-eastern Europe, being independent to a certain risk factor. We aim to present hypertension control over a short period of time for a cohort of ACS patients admitted in an urban cardiovascular center, followed for 6 months. Design and method: We selected a cohort of patients admitted in hospital over 1 month, October 2024. We choose an autumn month avoiding influences of the continental temperate climate, with extreme temperatures during winter and summer. We considered patients with UA, ACS, NSTEMI, STEMI, irrespective of invasive strategy followed. Patients’ data were collected from medical notes. A telephone interview was performed for 6 months follow-up. The signed informed consent allowed contacts for medical and research purposes. We analyzed data using SPSS 20, Chicago, USA. Results: 44 patients were admitted with ACS during October 2024, all receiving coronary angiogram. 36 (81.8%) received invasive revascularization, the remaining 8, 2 were referred to surgery, 2 had non-significant atherosclerotic plaques, 4 diagnosed with MINOCA. We contacted all 44 surviving patients at 6 months. 42 (95.5%) performed outpatient control after ACS. The median BP at discharge was SBP 150.4±24.7, DBP 85.3±16.1 mm Hg. Patients were treated for hypertension with 2.8 ±1.2 classes of drugs (RASS blockade, MRA, CCB, BB, diuretics, Central sympathetic inhibitors (CSI)). At 6 months mean BP values were SBP 129.8±12.2, DBP 79.7±7.0 mm Hg respectively. BP control improved with 20.6±21 mm Hg SBP* and 5.6±16.3 mm hg DBP* (*p<0.05) under a similar number of drugs (2.8±1.3 classes, change non-significant). Left ventricle ejection fraction (LVEF) did not change (increase from 44.4±7.9 to 46.7±6.9%, change non-significant), irrespective of revascularization status. Conclusions: The moderate levels of hypertension in the acute studied cohort, associated with adequate number of drugs and good adherence, allowed a better BP control compared to general population, irrespective of LV dysfunction and revascularization status. Persistence on medication is one of the key components of morbi-mortality improvement.