Ambulatory Blood Pressure Control Pattern in Hypertensive Patients at Tikur Anbesa Specialized Hospital: A Cross Sectional Study
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Date
2021-05
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Addis Abeba University
Abstract
Background: Hypertension is the most common cardiovascular problem
globally with a particularly increasing burden in developing countries
like Ethiopia. Ambulatory blood pressure (ABPM) is superior to office
blood pressure (OBP) measurement for diagnosing, prognosticating
and following treatment efficacy for hypertension. There is no available
data on ABPM control pattern in Ethiopians. This study will determine
the ABPM control patterns in Ethiopian hypertensive patients on
treatment.
Material and Methods: This was a cross sectional study in hypertensive
patients at Tikur Anbessa Specialized Hospitals outpatient departments
carried out during January to May 2021. ABPM values of 244
consecutively sampled patients were analyzed. All patients had their BP
monitored over 24 h with a Tonoport V (GE CS V6 71), and the data was
interpreted using GE CardiosoftTM ABPM software in accordance with
European Society of hypertension guidelines. Ethical clearance was
given by Addis Ababa University Institutional Review Board and the
study was conducted in compliance to standard ethical guidelines.
Results: The study involved 244 adult hypertensive patients; mean age
of the patients was 59.4years and, 54% were females. 58.6% of patients
had controlled OBP, while only 45.1% had controlled ABPM. The mean
OBP was 137 (19)/81 (10) mmHg and mean 24-hr ABP was 137 (16)/81
(10) mmHg; mean daytime BP was 136/79 ± 17/11 mmHg; mean
night-time BP, 138/84 ± 16/11 mmHg. Mean ABPM values were not
significantly different between men and women. Comparison of ABPM
values with OBP revealed high prevalence of the white coat effect
(32%) and masked uncontrolled hypertension (46%). Presence of
comorbidities particularly diabetes predicted poor ABPM control.
Conclusion: More than half of patients had uncontrolled BP as per
ABPM criteria and significant discrepancy exists between ABPM and
OBP in assessing adequacy of BP control. Guiding management
decisions using ABPM can improve BP control rates.
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Keywords
Blood Pressure,Ambulatory,Hypertensive Patients