Prognostic value of ambulatory blood pressure monitoring in treated hypertensive patients

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Published Jul 11, 2023
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Vol. 101 No. 2 (2023): Issue Feb 2023

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Saoussen Antit
University of Tunis El Manar, Faculty of Medicine of Tunis, Security Forces Hospital of Marsa, Cardiology Department, Tunisia
Ridha Fekih
Department of Nephrology, Dialysis, and Transplantation - Sahloul University Hospital, Sousse, Tunisia.
Cyrine Antit
Department of Nephrology, Dialysis, and Transplantation - Sahloul University Hospital, Sousse, Tunisia.
Marwa Abdelhedi
Department of Nephrology, Dialysis, and Transplantation - Sahloul University Hospital, Sousse, Tunisia.
Elhem Boussabeh
Department of Nephrology, Dialysis, and Transplantation - Sahloul University Hospital, Sousse, Tunisia
Lilia Zakhama
- Department of Nephrology, Dialysis, and Transplantation - Sahloul University Hospital, Sousse, Tunisia.

Abstract

Introduction : Ambulatory blood pressure monitoring (AMBP) has become a valuable tool for analyzing patient blood pressure (BP) pro-file to make a more accurate prognosis compared to clinical office BP.
Aim: To identify the prognostic value of different parameters of ABPM and the future course of cardiovascular events (CVE) in treated hypertensive patients.

Methods : We conducted a prospective, descriptive study, including treated hypertensive patients which had consulted between 2015 and 2016 and had a systematic ABPM during their follow-up. Patients were followed at the outpatient clinics for 4 years, and we searched in the computerized medical file the occurrence of CVE.

Results : A total of 240 patients were included in our study with masculine predominance (57%). The mean age was 57.4±9.5 years. During 4 years of follow-up, 30 patients (12.5%) experienced a CVE. The total number of CVE was 32: acute heart failure (3), acute co-ronary syndrome (15), atrial fibrillation (12), stroke (2). Daytime systolic blood pressure (SBP), night-time SBP, 24-h SBP and 24-h pulse pressure (PP), had similar performances to predict CVE. Only the 24-h PP (OR= 1.072; 95% IC: 1.019-1.128; p= 0.007) was found to be an independent predictor of CVE. A 24-h PP> 55 mmHg increased the risk of CVE by 3.2.

Conclusion : SBP and PP were associated with CVE in treated hypertensive patients. the 24-h PP was found to be an independent pre-dictor of CVE so it may serve as a therapeutic target in hypertension therapy.

Keywords:

Ambulatory blood pressure monitoring, hypertension, prognosis

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