Cardiovascular
Cardiac Rehabilitation Participation Association with Blood Pressure Trajectories in UCSF Health Patients Joan Shim* Joan Shim Alexis
Importance: Blood pressure (BP) trajectories, or patterns of BP over time, are can identify cardiovascular disease risk. Cardiac rehabilitation (CR) may help improve BP control.
Objective: The main objective of this study is to identify subgroups of individuals with similar BP trajectories and to determine the relationship of BP trajectories with CR among patients at UCSF Health eligible for CR.
Design, Study, and Participants: We analyzed electronic medical records from UCSF Health in this retrospective cohort study, in which participants discharged from UCSF hospitals were selected based on eligibility of CR from September 2019 to January 2023. Group based trajectory modeling was used to determine BP trajectory groups, and we used logistic regression to assess the association between CR participation and BP trajectories, adjusting for age, gender, race/ethnicity, marital status, smoking, and socioeconomic status.
Main Outcomes and Measures: Two or more measurements of systolic BP (SBP) and diastolic BP (DBP) were clinically recorded at least one year after hospital discharge. BP control was defined by BP measurements averaging less than 130/80. CR participation was identified through CPT Code 93797 or 93798.
Results: In 3,282 patients (37% female;mean age 68 years[SD=15];7% CR participation), there were three SBP (Low SBP, Medium SBP, High SBP) and two BP control trajectories (BP Controlled, BP Uncontrolled). Participating in CR was associated with a lower odds of high SBP versus the middle and low SBP trajectories (adjusted OR=0.65;95%CI=0.50,0.85). Participating in CR was associated with a higher odds of controlled BP versus uncontrolled BP trajectory (adjusted OR=1.68;95%CI=1.25,2.25).
Conclusions and Relevance:
Participation in CR has a protective association against high BP and is associated with increased odds of a controlled BP. Future research should focus on how to best incorporate this knowledge into clinical care to reduce the burden of hypertension.
