A b s t r a c tBackground: Risk assessment is of particular importance for patients undergoing surgical interventions. Orthopaedic procedures, especially total joint alloplasty, are major procedures associated with high perioperative risk, as well as one of the highest rates of complications. Aim:The aim of the present study was to establish the prevalence of classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty. Methods:The CRASH-JOINT (Cardiovascular Risk Assessment ScHeme in JOINT alloplasty) was a prospective, epidemiological study performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery. Patients enrolled into the study were screened for cardiovascular risk factors and had ambulatory blood pressure performed for the diagnosis of hypertension.Results: The present study enrolled 98 patients. During initial screening eight patients were disqualified from the study and the surgery, in the majority due to the cardiac causes. Sixty-five patients had a hip joint replacement and 25 had knee joint replacement (mean age 63.7 ± 12.2 years, 62.2% female). Fifty (55.6%) patients were diagnosed with arterial hypertension in the past, ten (11.1%) patients had diabetes mellitus, two (2.2%) had a history of myocardial infarction, and family history of cardiovascular disease was present in 24 (26.7%) cases. Mean body mass index (BMI) was 28.0 ± 5.1 kg/m 2 and 39 (43.3%) patients were overweight, while 28 (31.1%) were obese. Patients undergoing hip replacement were significantly younger (61.8 ± 12.6 vs. 68.5 ± 10.0 years; p = 0.02), were more often current smokers (24.6% vs. 4.0%; p = 0.03), had significantly lower BMI (26.8 ± 4.5 vs. 31.2 ± 5.3 kg/m 2 ; p < 0.0001), and were less often obese (18.5% vs. 64.0%; p < 0.0001). There were no significant differences between patients scheduled for primary surgery and reoperation. Conclusions:The study showed that classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty have a higher prevalent than in the general population, which can potentially contribute to the higher risk of development of perioperative complications.

Background Arterial hypertension is one of the major cofounders in the development of atrial fibrillation (AF) and hypertension is commonly found in AF patients. The aim of the study was to establish the prevalence of arterial hypertension in patients undergoing ablation, who are relatively young and healthy group of AF patients. Material and methods 266 consecutive patients admitted for AF ablation were screened for arterial hypertension. All patients had their blood pressure measured on admission by, prior to the ablation procedure by a qualified physician, according to the current guidelines. Also, medical records of patients were reviewed for the previous diagnosis of hypertension or taking hypotensive agents. Results The study group was predominantly male (65.0%; mean age 57.6 ± 10.1 years). Mean body mass index was 29.7 ± 5.0 kg/m 2 . Paroxysmal AF was present in 69.5% of patients. In 72.9% of patients hypertension was diagnosed previously. On admission, mean systolic and diastolic blood pressure values were 131.7 ± 16.7 and 80.7 ± 11.1 mm Hg. 123 (46.2%) patients had systolic and/or diastolic blood pressure values respectively > 140 and/ /or > 90 mm Hg. Patients with previously diagnosed hypertension were older (58.7 ± 8.7 vs 54.6 ± 12.7 years; p = 0.003), had higher BMI (30.3 ± 5.0 vs 28.1 ± 4.8 kg/m 2 ; p = 0.002), and more often history of diabetes (10.8% vs 1.4%; p = 0.03) compared to non-hypertensive group. There were no differences in terms of history of dyslipidaemia, stroke, myocardial infarction or family history of cardiovascular disease. Conclusions In patients with AF undergoing ablation procedure, prevalence of diagnosed arterial hypertension is very high, much higher than in the general population. Nevertheless, majority of patients meet the criteria for adequate blood pressure control. key words: arterial hypertension, atrial fibrillation, ablation

Background: Assessment of blood pressure values and early diagnosis of hypertension are especially important in high-risk group, including patients in preoperative and postoperative period. The aim of the current study was the assessment of blood pressure values and prevalence of hypertension in patients undergoing elective hip replacement surgery-an orthopedic procedure associated with one of the highest cardiovascular complication rate. Material and methods: Two hundred and eighty-four consecutive patients admitted for elective hip replacement surgery were screened for arterial hypertension. All patients had their medical records reviewed for prior diagnosis and had their blood pressure measured on admission by a qualified physician prior to the procedure, according to the current guidelines. Results: The mean age of the study population was 62.2 ± 13.9 years and 42.7% of the patients were male. The body mass index (BMI) in the study population was 27.0 ± 4.2 kg/m 2. Fifty-eight point two percent of patients were diagnosed with arterial hypertension previously. Mean blood pressure values on admission for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 134.5 ± 20.4 and 78.6 ± 13.1 mm Hg, respectively. In 43.2% of patients, the on admission blood pressure values exceeded the threshold of ≥ 140 and/or 90 mm Hg. Arterial hypertension was diagnosed de novo in 33 (15.0%) patients. Patients with the disease were older (67.5 ± 12.3 vs. 54.4 ± 13.9 years; p < 0.0001), and had higher BMI (27.6 ± 4.3 vs. 26.2 ± 3.8 kg/m 2 ; p = 0.05) than patients without the diagnosed disease. Diabetes mellitus was more often found in hypertensive patients (13.3% vs. 3.3%; p = 0.02), they also more often had history of myocardial infarction (p = 0.02), stable coronary artery disease (p = 0.001) and heart failure (p = 0.006) compared to patients without the diagnosis. Conclusions: The majority of patients scheduled for elective hip replacement surgery is diagnosed with arterial hypertension. The disease is also diagnosed de novo in 15% of these patients. Screening for arterial hypertension is important in this group of patients and can potentially reduce the complication rates of the hip replacement surgery.

Background. Total hip replacement is a common orthopaedic procedure associated with an elevated cardiovascular risk. There are several methods for total hip replacement, including whether or not to use cement for the prosthesis fixation. The aim of the study was to compare clinical characteristics, including blood pressure, in patients undergoing total hip replacement with and without the use of cement. Material and methods. The study included patients with elective total hip replacement surgery, who were divided into those in whom the procedure was performed with or without the use of medical cement. The criteria for using cement were assessed during operation by the operator, according to the current protocol. All patients were interviewed, screened, and had their medical records checked for the prior diagnosis of cardiovascular risk factors. Blood pressure values were measured before and after the procedure according to the current guidelines. Results. The study population consisted of 65 patients in whom the total hip replacement was performed (mean age 61.5 ± 15.0 years; 50.8% male). 60% of patients had the hip replacement without cement and 40.0% had a procedure with the use of cement. Patients in whom the cement was used were significantly older (75.0 ± 8.5 vs. 53.0 ± 11.5 years; p < 0.0001) and more often diagnosed with arterial hypertension (61.5 vs. 33.3%; p = 0.04), than those in whom it was not used. Systolic blood pressure values were significantly higher before and after the procedure (138.8 ± 18.2 vs. 130.8 ± 21.5 mm Hg, p = 0.04; 122.6 ± 13.3 vs. 113.8 ± 14.1 mm Hg, p = 0.03; respectively) in the group which required cement. Conclusions: Patients with hip replacement using cement have higher systolic values before, and after the surgery than in patients in whom cement wasn't used. Therefore careful management and risk assessment is especially important in patients receiving the total hip replacement with the use of cement.

No abstract