THE DISABILITY IN HYPERTENSIVE PATIENTS WITH CORONARY HEART DISEASE AFTER CORONARY INTERVENTION WITH ANGIOPLASTY AND STENTING

Background. Cardiovascular diseases, in particular coronary heart disease (CHD) associated with hypertension, are an important medical and social problem.

Objective. To study the effects of hypertension on primary disability in patients with CHD after percutaneous coronary intervention — coronary angioplasty and stenting.

Design and methods. The study was conducted in the office of medical and social examination (St Petersburg). The main group consisted of 65 hypertensive (III grade) patients with CHD after coronary stenting. The comparison group included 49 patients with CHD without known hypertension.

Results. There was a higher occurrence of left ventricular hypertrophy (LVH) (92,3 and 69,4 %, p < 0,01), more severe impairment of LV systolic function (ejection fraction — 56,3 ± 1,1 and 48,1 ± 1,0 %, p < 0,001), lower tolerance to physical load, more severe chronic heart failure in hypertensive patients with CHD compared to non-hypertensive subjects. Evaluation of clinical outcomes of coronary stenting showed higher re-occurrence rate of CHD symptoms in hypertensive patients than in the comparison group (27,7 and 12,2 % respectively, p < 0,05). The rate of disability was higher in hypertensive patients with CHD compared to subjects with normal blood pressure.

Conclusion. Hypertensive patients with CHD and high blood pressure have poorer outcomes of percutaneous coronary intervention procedures, higher rate of disability and require more rehabilitation procedures.

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