Poorly controlled ambulatory blood pressure in outpatients with peripheral arterial disease

  • Nina Dahle Centre for Clinical Research, Uppsala University, Falun, Sweden; and Primary Health Care Center Britsarvet-Grycksbo, County of Dalarna, Falun, Sweden https://orcid.org/0000-0003-1444-2515
  • Emma Skau Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden; and Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden https://orcid.org/0000-0002-5625-1146
  • Jerzy Leppert Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden https://orcid.org/0000-0003-1433-0329
  • Johan Ärnlöv Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; and School of Health and Social Studies, Dalarna University, Falun, Sweden https://orcid.org/0000-0002-6933-4637
  • Pär Hedberg Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden; and Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden https://orcid.org/0000-0001-5731-966X
DOI: https://doi.org/10.48101/ujms.v126.7609
Keywords: Carotid artery disease, cardiovascular risk factors, hypertension, smoking, hyperlipidemia, preventive efforts

Abstract

Background: Patients with peripheral arterial disease (PAD) are generally less intensively managed than patients with coronary heart disease (CHD), despite that their risk of complications is believed to be equivalent. Identification of PAD patients at risk of poorly controlled blood pressure (BP) could lead to improved treatment, thus lowering the risk of cardiovascular (CV) complications. We aimed to describe the prevalence of poorly controlled cardiovascular (CV) risk factors, focusing on BP, in outpatients with PAD diagnosed in a vascular ultrasound laboratory.

Methods: Consecutive outpatients with carotid and/or lower extremity PAD were included (n = 402) and examined with blood sampling, clinical BP, and 24-h ambulatory BP measurements. A poorly controlled clinical BP was defined as ≥140/90 mmHg, ambulatory BP ≥130/80 mmHg, low-density lipoprotein (LDL)-cholesterol level ≥2.5 mmol/L, and glycated hemoglobin (HbA1c) level >53 mmol/mol in those with diabetes.

Results: Most of the patients had poorly controlled clinical (76.6%) and ambulatory BP (51.7%) profiles. Antihypertensive medications were prescribed in 84% of the patients. However, >40% of them used only 0–1 medication, and <25% of them used three or more agents. Clinical BP, a low number of medications, body mass index, and the presence of diabetes independently predicted a poorly controlled ambulatory BP. Nearly one-third of the patients were smokers, and most of the cohort had an LDL-cholesterol level of ≥2.5 mmol/L. An HbA1c level of >53 mmol/mol was present in 55% of diabetic patients.

Conclusion: Poorly controlled clinical and ambulatory systolic BP profiles were common. In addition, suboptimal control of other important CV risk factors was detected. The findings of this study highlight the need for better preventive efforts against CV risk factors in outpatients with PAD.

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Published
2021-04-29
How to Cite
Dahle N., Skau E., Leppert J., Ärnlöv J., & Hedberg P. (2021). Poorly controlled ambulatory blood pressure in outpatients with peripheral arterial disease. Upsala Journal of Medical Sciences, 126(1). https://doi.org/10.48101/ujms.v126.7609
Issue
Vol. 126 (2021): Upsala J Med Sci
Section
Original Articles
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