PATTERN OF HYPERTENSIVE PATIENTS WITH LEFT VENTRICULAR EJECTION FRACTION < 40% AFTER CARDIAC REHABILITATION

Objective: Arterial hypertension is a major risk factor for cardiovascular (CV) disease, often associated with coronary artery disease as a cause or aggravator. Its prevalence in the elderly has led to an increase in heart disease, with many patients hospitalised for heart disease having a reduced left ventricular ejection fraction (LVEF). This affects mobility (balance, walking and self-care), delays recovery, increases complications, increases hospital days and exacerbates patient weakness. Aim Evaluate the physical condition of post-CV event patients after phase I cardiac rehabilitation, comparing profiles of hypertensive (BP>140/90mmHg) vs. non-hypertensive patients. Design and method: Longitudinal, prospective study in hospitalised patients with heart disease. Physical fitness was assessed: dynamic balance and mobility (Fullerton test battery) and handgrip strength test. Morisky Medication Adherence Scale, STOP-Bang scale, London Chest of Daily Living (LCADL), International Physical Activity Questionnaire (IPAQ) and Hospital Anxiety and Depression Scale (HADS) were also used. Descriptive and inferential analyses were performed using R version 4.2.2, with p-values less than 0.05 considered significant. Results: On the day of discharge, 212 patients were assessed (median age 66 years, IQR 57–74), 35% had LVEF <40%, 73% hypertension, 75% dyslipidaemia, 62% daily alcohol habit, and 17% regular exercise. On Fullerton test, 69% needed >4 steps to turn 360°; 92% failed straight-line walking; 84% could not balance on one leg for 20 seconds. Additionally, 29% scored high on the Morisky scale, and 58% were at high risk for sleep apnoea. Comparing the hypertensive (n=154) and non-hypertensive (n=58) groups, the hypertensive patients were: older (p-value = 0.003), more dyslipidaemic (p-value = 0.005), smokers (p-value < 0.001), and had a higher body mass index, abdominal and neck circumference (all p-value < 0.001), risk of sleep apnoea (p-value < 0.001). They also had lower Morisky scale scores (p-value = 0.032), LCADL scores (p-value = 0.045) and a higher risk of depression (p-value = 0.016). But, in the Fullerton battery, only arm and leg flexibility showed a statistically significant difference (p-value <0.05). Conclusions: Patients with hypertension have a higher cardiovascular risk and poorer adherence to treatment, making the benefits of cardiac rehabilitation important.