No abstract

No abstract

Background and Objective. The aim of this study was to evaluate blood pressure (BP) control level in treated hypertensive patients in Latvia and to compare their characteristics according to the adequacy of BP control. Materials and Methods. Family physicians collected information on demographic and clinical characteristics, and current antihypertensive treatment of 455 18–80-year-old patients with essential arterial hypertension treated for 1 or more years. Target BP was defined as values of <140/90 mm Hg for patients with low or moderate cardiovascular risk and <135/85–125/75 mm Hg for patients with high or very high risk. BP was measured in the office setting after a 5-minute rest in a sitting position using a calibrated aneroid sphygmomanometer. Results. Nearly half of patients (46.2%) attained their target BP. The proportion of patients with effective BP control was higher in the group of low and moderate added cardiovascular risk than in the high and very high added cardiovascular risk group (61.7% vs. 34.4%, P<0.0001). The majority of patients were given two-drug (26.2%) or three-drug (31.6%) combined antihypertensive therapy. Current pharmacological treatment was similar in the patients who attained target BP and in those who did not. Overall, physicians did not modify antihypertensive treatment in 37.9% of patients; such a recommendation was more common among patients with controlled BP. Very few patients (7.4%) who did not attain target BP did not receive recommendations to modify antihypertensive treatment. Conclusions. The rate of effective BP control was less than 50% and was even worse (34.4%) in patients with high or very high added cardiovascular risk in the present sample of treated hypertensive patients.

No abstract

Background It is widely accepted that patients with rheumatoid arthritis (RA) have increased mortality and morbidity from premature cardiovascular disease. Up to 50% of this mortality excess is secondary to ischemic heart disease closely followed by cerebrovascular disease [1]. Objectives To investigate intima-media thickness (IMT) and plaque formation with relation to age, disease duration and disease severity, myocardial infarction (MI) and stroke in patients with RA in order to detect and estimate cardio and cerebrovascular risk factors and events. Methods Forty five patients (female 91.1%) with confirmed RA (aged 20-82) were selected. Carotid artery hemodynamic parameters, IMT and plaques were measured by using high resolution B-mode and Doppler–mode ultrasound to detect blood flow velocities, maximal IMT, size of atherosclerotic plaques. Rheumatoid arthritis severity was measured by DAS28, SDAI, CDAI scores and HAQ questionnaires. For cardiovascular risk detection Framingham risk score and AIP (Atherogenic Index of Plasma (log10 TG/HDLC)) were used. Data analysis was performed using IBM SPSS 21.0. Results Patients with previous MI were statistically significant older than patients without MI (69.0±10.6 and 52.7±15.7 years, respectively). Previous MI had 13.33% of patients, and previous stroke 4.44% of patients. There were no statistically significant correlations between atherosclerotic plaques on the right and left side of brachiocephalic vessels, IMT dx and sin, and the duration of RA and the age when diagnosis was confirmed (p>0.05). Statistically significant correlation between IMT sin and age of patients was found (r=0.63; p<0.001); IMT dx and age of patient (r=0.62; p<0.001). No statistically significant correlations between IMT dx and sin, atherosclerotic plaques dx and sin and activity markers of RA (p>0.05) were found. The duration of disease was not statistically longer for patient with MI than for patients without MI (p=0.34). Atherosclerotic lesions were not more pronounced to patients with MI than without (p=0.80). Anti CCP levels did not differ between patients with and without MI (p=0.900). Conclusions Previous MI did not show significant association with BMI, smoking habits, atherosclerotic lesions of vessels (atherosclerotic plaques), disease severity, activity markers and AIP. This preliminary observation indicates the changes of immune system long before appearance of RA, triggering severe cardiovascular events without traditional cardiovascular risk factors. References Wallberg-Jonsson S, Ohman ML, Dahlqvist SR:Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in Northern Sweden. J. Rheumatol 1997;24:445–51. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.5841