BETTER CONTROL OF HYPERTENSION IN PATIENTS WITH PACEMAKER?

Aim: To evaluate the influence of pacing on blood pressure level (BP) in patients treated for hypertension.
Study Group and Methods: The retrospective analysis of the group of 259 patients with treated hypertension, in who the implantation of pacemaker (PM) was performed at our department within the period of years 2004 – 2006. There were 134 men (52%), the mean age of the patients was 74±9 years (median 75 years). We investigated the BP before and after PM implantation and also other factors influenting BP. Good controlled hypertension was considered as  BP<140/90 mmHg, BP≥140/90 mmHg as a worse controlled hypertension.
Results: Before PM implantation the mean systolic BP was 146±25 mmHg (median 145 mmHg) and the mean diastolic BP 82±14 mmHg (median 80 mmHg); in 79 (30,5%) patients was BP<140/90 mmHg, BP≥140/90 mmHg in 80 (69,5%) patients. After PM implantation the mean systolic BP was 130±16 mmHg (median 130 mmHg) and the mean diastolic BP 76±11 mmHg (median 80 mmHg); BP<140/90 mmHg was measured in135 (52%) patients and BP≥140/90 mmHg in 124 (48%) patients. There was statistically significant decrease in the rate of patients with worse controlled hypertension (p<0,001). We also found statistically significant increase in the rate of patients treated by betablockers (BB) after PM implantation (p<0,001). There were 128 (49%) patients treated by BB before PM implantation, and 177 (68%) patients after the implantation.
Conclusion: We discovered significantly decrease of BP after implantation PM in our
patients. And it can be said, that pacing could also improve the control of hypertension, particularly due to possibility of  treatment by BB in those patients, who could not use BB before, because of bradycardia.