Ambulatory blood pressure monitoring in the diagnosis and management of arterial hypertension in current medical practice in Algeria

Objectives: There are limited data on the management of hypertension (HT) in Algeria. The aim of this study was to assess in current medical practice the use and benefits of ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of HT. Methods: A prospective, observational, multicenter study was performed in 2017. Patients aged ≥ 18 years with suspected or treated HT were included. A 24-hour ABPM was performed at baseline in all patients. Therapeutic decision was taken according to ABPM results and patients were then followed up to 6 weeks. Results: The analysis included 1027 patients (mean age, 51.0 years; women, 61.6%) with treated HT (37.3%) or suspected HT (62.7%). Major cardiovascular risk factors were diabetes (15.7%) and lipid disorders (7.2%). Daytime ABPM was pathological in 55.1% of patients on antihypertensive treatment and in 60.8% of patients with suspected HT. A therapeutic adjustment or a treatment switch was performed after pathological ABPM in 37.4% of patients already on antihypertensive treatment and an antihypertensive therapy was initiated in 54.9% of patients with initially suspected HT. Therapeutic strategy was mainly based on monotherapy regimen in 35.8% of patients with treated HT and in 69.3% of patients with initial suspicion of HT. Most frequent treatments used angiotensin receptor antagonists (55.3% and 50.0%, respectively). Comparable findings were observed 6 weeks later. Conclusions: This study is the first evaluation of the usefulness of ABPM for the management of HT in Algeria. Our results emphasize that ABPM is a highly valuable method for avoiding the white-coat effect and for detecting patients who are insufficiently treated with antihypertensive drugs.

Download Full-text

Ambulatory blood pressure monitoring-based definition of true arterial hypertension

Minerva Medica ◽

10.23736/s0026-4806.20.06834-2 ◽

2020 ◽

Vol 111 (6) ◽

Author(s):

Ramón C. Hermida ◽

Artemio Mojón ◽

José R. Fernández ◽

Alfonso Otero ◽

Juan J. Crespo ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Definition Of

Download Full-text

The Key Role of Ambulatory Blood Pressure Monitoring in the Detection of Masked Hypertension and Other Phenomena in Frail Geriatric Patients

Medicina ◽

10.3390/medicina57111221 ◽

2021 ◽

Vol 57 (11) ◽

pp. 1221

Author(s):

Marek Koudelka ◽

Eliška Sovová

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Geriatric Patients ◽

Blood Pressure Monitoring ◽

Target Range ◽

Masked Hypertension ◽

Pressure Monitoring

Background and Objectives: This study aims to determine prevalence of masked uncontrolled hypertension (MUH) in frail geriatric patients with arterial hypertension and thus show the role of ambulatory blood pressure monitoring (ABPM) since hypertension occurs in more than 80% of people 60+ years and cardiovascular diseases are the main cause of death worldwide. Despite modern pharmacotherapy, use of combination therapy and normal office blood pressure (BP), patients’ prognoses might worsen due to inadequate therapy (never-detected MUH). Materials and Methods: 118 frail geriatric patients (84.2 ± 4.4 years) treated for arterial hypertension with office BP < 140/90 mmHg participated in the study. 24-h ABPM and clinical examination were performed. Results: Although patients were normotensive in the office, 24-h measurements showed that BP values in 72% of hypertensives were not in the target range: MUH was identified in 47 (40%) patients during 24 h, in 48 (41%) patients during daytime and nocturnal hypertension in 60 (51%) patients. Conclusions: ABPM is essential for frail geriatric patients due to high prevalence of MUH, which cannot be detected based on office BP measurements. ABPM also helps to detect exaggerated morning surge, isolated systolic hypertension, dipping/non-dipping, and set and properly manage adequate treatment, which reduces incidence of cardiovascular events and contributes to decreasing the financial burden of society.

Download Full-text