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Abstract: SA-PO538

Blood Pressure Is Not Controlled to <130/80 mm Hg in Majority of Veterans with High Atherosclerotic Cardiovascular Disease (ASCVD) Risk

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Zghayer, Aseel, Loyola University Health System, Maywood, Illinois, United States
  • O'Halloran, Meghan, Edward Hines Junior VA Hospital, Hines, Illinois, United States
  • Huo, Zhiping, Edward Hines Junior VA Hospital, Hines, Illinois, United States
  • Weaver, Frances M., Loyola University Health System, Maywood, Illinois, United States
  • Hughes, Ashley Marie, University of Illinois Chicago, Chicago, Illinois, United States
  • Stroupe, Kevin, Loyola University Health System, Maywood, Illinois, United States
  • Markossian, Talar, Loyola University Health System, Maywood, Illinois, United States
  • Kramer, Holly J., Loyola University Health System, Maywood, Illinois, United States
Background

Blood pressure (BP) control remains the most effective intervention to prevent cardiovascular disease (CVD). The American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline recommends a BP goal <130/80 mmHg for adults with high CVD risk which includes individuals with existing ASCVD, diabetes mellitus (DM) or chronic kidney disease (CKD). Few studies have examined the proportion of Veterans with CVD, DM or CKD with BP controlled to <130/80 mmHg receiving care within Veterans Affairs patient aligned care teams (PACT).

Methods

Vital sign data were obtained from 98,433 Veterans aged 18 to 85 years with a hypertension diagnosis during a PACT visit within eight Veteran Integrated Service Network 12 medical centers from January 1,2019, through March 1,2020. BP control was examined by high CVD risk (age ≥ 65 years and/or CVD, DM or CKD) and by presence of CVD, DM, CKD based on ICD10 diagnosis codes, or estimated glomerular filtration rate < 60 ml/min/1.73 m2 on two occasions based 90 days apart prior to the end of the study period. BP control was defined as a systolic BP <130 mmHg and diastolic BP <80 mmHg based on BP recorded during the last PACT clinic visit during the study period.

Results

The mean age was 68.5 years (SD 12.7) and 93% were male. Among the 89,537/98433 Veterans with high CVD risk, BP was controlled to <130/80 mmHg in 37.5% and <140/90 mmHg in 76.5%. Among subgroups, BP was controlled to <130/80 mmHg in 42.8% (5313/12,414) with CKD, 39.8% (13,484/33,880) with diabetes, 45.3% with CVD (13,402/29,584) and in 47.1% (1810/3845) with CKD, DM and CVD. In contrast, BP was controlled to <140/90 mmHg in over 75% of Veterans with CKD, DM and/or CVD. (Figure 1).

Conclusion

The majority of Veterans with high CVD risk did not have BP controlled to < 130/80 mmHg. Strategies are needed to improve BP control in Veterans with high CVD risk.

Figure 1.