[Pp.12.21] Detection of Risk Factors for an Escape of the Antihypertensive Therapy Efficacy

Objective: To determine risk factors for the escape of the antihypertensive (AHT) therapy efficacy leading to a treatment adjusting during three months after hospital discharge.Design and method: The study included 59 patients with essential arterial hypertension (HT) grade 1–3, and without other cardiovascular disease (CVD), chronic kidney disease stage >3 or diabetes. Mean age was 55 ± 9 years, 29 men. Efficacy of the prescribed AHT drugs (2–3 medications from different AHT drug classes) was verified just before inclusion in the study by 24-hour blood pressure (24-BP) monitoring (using 24-BPM, BpLab) in the hospital. All included patients have achieved a mean 24-BP ∼ 130/80 mmHg. We monitored AHT therapy efficacy for 3 months following hospital discharge. Compliance was assessed by monitoring a ratio of taken and prescribed pills during office visits (at the 1st and 3rd month after hospital discharge). There were AHT therapy effectiveness criteria: office BP<140/90 mmHg (oscillometric method, OMRON), home BP<135/85 mmHg (oscillometric method, AND), 24-hour ambulatory BPM<130/80 mmHg (at the 1st and 3rd month after hospital discharge). In case of registering of higher levels of the BP by anyone method, we provided the AHT treatment adjusting. Results: Patients were divided into two groups by the presence (Group1, n = 29) or absence (Group2, n = 30) of indications for the treatment adjusting. The characteristics of groups and number of significant differences are shown in the Table1. Univariate logistic regression analysis was used with the following results: odds ratio (OR) for the escape of the AHT therapy efficacy increased by 18% with increase of the mean 24-SBP in each 1 mmHg (p = 0,004, OR = 1,18; 95% confidence interval (CI) 1,05–1,33), and by 60% with increase of the levels of the FG in each 0,5 mmol/l (p = 0,02, OR = 1,60; 95%CI 1,06–2,4). In the multivariate logistic regression analysis, independent risk factors for the escape of the AHT therapy efficacy were: family history of the early CVD (p = 0,03, OR = 3,7, 95%CI 1,1–12,1) and IGT (p = 0,04, OR = 4,1, 95%CI 1,02–16,4). Conclusions: There were detected risk factors for the escape of the AHT therapy efficacy: smoking, family history of the early CVD, IGT, level of the FG, mean 24-SBP.