Effect of cardiac rehabilitation on 24-hour blood pressure variability in patients with ischemic heart disease

Aim: It is known that blood pressure variability in hypertensive patients is associated with target organ damage and cardiovascular mortality independent of blood pressure level. Studies have shown that there is a significant decrease in long-term mortality from any cause after cardiac rehabilitation, and the effect of cardiac rehabilitation on blood pressure variability has not been clarified yet. Therefore, the effect of cardiac rehabilitation on blood pressure variability in hypertensive patients with ischemic heart disease was investigated. Materials and Methods: The study was started after the approval of the local ethics committee (date and no: 05.10.2022-169). The study was planned retrospectively, and a total of 151 patients with a diagnosis of hypertension and ischemic heart disease, who had a history of coronary stent and/or coronary By-pass followed, and who were included in the cardiac rehabilitation program were included in the study. Showing the blood pressure variability mean true variability (ARV) (systolic, diastolic, mean arterial pressure, night time systolic and nighttime diastolic) values were obtained by mathematical calculation from the measurements of the patients whose blood pressure measurements were taken at 15-minute intervals during the day and 30-minute intervals for 24 hours before and after the three-month cardiac rehabilitation program using ABPM devices. Correlation between cardiac rehabilitation and ARV was evaluated. Results: According to the baseline measurements, the decrease in the 24-hour systolic, diastolic and mean arterial blood pressures of the patients after the cardiac rehabilitation program was significant (p< 0.001 for all). Similarly, decreases in 24-hour systolic, diastolic, mean arterial, nocturnal systolic, and nocturnal diastolic ARV values were also found to be significant compared to baseline ARV values (p< 0.001 for all). When subgroup analyzes were analyzed in terms of diabetes mellitus, congestive heart failure, obesity, age, gender, smoking, type of antihypertensive treatment used, coronary stent and/or By-pass history, no significant difference was found in blood pressure variability before and after cardiac rehabilitation (p> 0,05 for all). Conclusion: After cardiac rehabilitation, a decrease was detected in 24-hour systolic, diastolic, mean arterial pressure, nocturnal systolic and nocturnal diastolic blood pressure VIII variability compared to baseline. Based on these results, it was thought that cardiac rehabilitation may play a regulatory role on 24-hour blood pressure variability and indirectly reduce the risk of cardiovascular disease. Keywords: Ischemic heart disease, blood pressure variability, hypertension, cardiac rehabilitation