Factors that contribute to poorly controlled blood pressure in coronary heart disease

This study looked at risk factors that may hinder blood pressure control in patients with high blood pressure and coronary heart disease. 

Cardioheart disease (CHD) is a heart disorder caused by narrowed or blocked blood vessels that supply the heart with blood and oxygen. CHD can lead to angina (chest pain), heart attack or stroke. High blood pressure, which is a measurement of how forcefully blood flows through arteries, increases the risk of CHD. High blood pressure causes the heart to have to work harder and can cause the blood vessels to thicken, narrowing the space that allows blood to flow through and result in CHD.

When blood pressure is measured, the value is given as two numbers. The first is the pressure inside arteries when the heart is contracting. This is called systolic blood pressure. The second number is the pressure inside arteries when the heart is relaxed. This is called diastolic blood pressure. Normal blood pressure is approximately 120/80 mmHg. 

This study surveyed 3,279 patients with CHD and hypertension across China. The average age of the patients was 65 years old, the average blood pressure was 118-154 over 69-91 and the average body mass index (BMI) was 35 kg/m². Uncontrolled hypertension was defined as blood pressure <130/or 80 mmHg. 

Analysis of patient characteristics found that body mass index >23 kg/m², the presence of stable angina pectoris (SAP – chest pain), family history of diabetes, and use of calcium channel blockers were associated with poor blood pressure control. This would suggest that patients with these characteristics should receive targeted interventions to improve blood pressure management and that calcium channel blockers are less effective than other therapies in controlling blood pressure among hypertensive patients with CHD.

This study suggests that the presence of obesity, SAP and family history of diabetes may affect blood pressure control in adults with coronary heart disease. 

Blood pressure is likely to change on a daily basis and this study only took blood pressure once, hence its accuracy is not known. Also there are a range of different calcium channel blockers used within the study that showed different effects on blood pressure and whether an effective dose of the drugs was given or compliance to taking the medication was adhered to is not known, therefore the suggestion that calcium channel blockers are less effective at controlling blood pressure needs clarification and further research. 

If you have high blood pressure and are obese or have SAP or family history of diabetes, ask your doctor what ways you can target these factors to help reduce the risk of developing coronary heart disease.