scholarly journals Ambulatory Blood Pressure Control Pattern in Hypertensive Patients at Tikur Anbesa Specialized Hospital: A Cross Sectional Study

Author(s):  
MULUALEM ALEMAYEHU ◽  
Sintayehu Abebe ◽  
Dejuma Yadeta ◽  
Bekele Alemayehu

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.

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015719 ◽  
Author(s):  
Shuna Yang ◽  
Wei Qin ◽  
Lei Yang ◽  
Huimin Fan ◽  
Yue Li ◽  
...  

ObjectivesRecent studies reported that 24-hour ambulatory blood pressure variability (ABPV) was associated with lacunar infarction and white matter hyperintensities (WMH). However, the relationship between ABPV and enlarged perivascular spaces (EPVS) has not been investigated. Thus, our study aimed to investigate whether ABPV is associated with EPVS by 24-hour ambulatory blood pressure monitoring (ABPM).DesignWe conducted this study as a cross-sectional study.SettingsThe study was based on patients who presented for physical examinations in our hospital from May 2013 to June 2016.ParticipantsPatients with both brain MRI scans and 24-hour ABPM were included and patients with acute stroke, a history of severe stroke and some other severe diseases were excluded. A total of 573 Chinese patients were prospectively enrolled in this study.Primary and secondary outcome measuresEPVS in basal ganglia (BG) and white matter (WM) were identified on MRI and classified into three categories by the severity. WMH were scored by the Fazekas scale. Coefficient of variation (CV) and SD were considered as metrics of ABPV. Spearman correlation analysis and ordinal logistic regression analysis were used to assess the relationship between ABPV and EPVS.ResultsThere were statistical differences among the subgroups stratified by the severity of EPVS in BG in the following ABPV metrics: SD and CV of systolic blood pressure (SBP), CV of diastolic blood pressure (DBP) in 24 hours, daytime and nighttime and SD of DBP in nighttime. The above ABPV metrics were positively associated with the degree of EPVS. The association was unchanged after adjusting for confounders. Spearman correlation analysis showed ABPV was not related to the degree of EPVS in the WM.ConclusionABPV was independently associated with EPVS in BG after controlling for blood pressure, but not in the WM. Pathogenesis of EPVS in BG and WM might be different.


2019 ◽  
Author(s):  
Assefa Iyasu Negash ◽  
Desta Siyoum ◽  
Tsega Hailemariam ◽  
Berihu Hailu Kidanu ◽  
Gebreamlak Gebremdhin Gebremeskel ◽  
...  

Abstract Background: - Uncontrolled hypertension is if SBP is ≥140 mm Hg and/or DBP ≥90 mm Hg for general hypertensive population or if SBP ≥130 mm Hg and/or DBP ≥80 mm Hg in patients with established diabetes mellitus or chronic kidney disease based on the average of two or more properly measured, seated, BP readings on each of two or more office visits. The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients in public hospitals of central zone, Tigray, Ethiopia, 2018. Methods:- A hospital based cross sectional study design was used. The study population was all sampled adult hypertensive patients who had follow up in public hospitals of central zone, Tigray and the data collection period was from March 01 to April 30, 2018. About 421 study participants were selected using systematic random sampling. Interviewer administered structured questionnaire, chart review checklist and measurements were used. The collected data was checked for its completeness manually and then entered and cleaned in to epi data version 3.1 and exported to Statistical packages for social science version 22 for analysis. Bivariate and multivariable analyses were done to identify factors of uncontrolled hypertension. Then those variables significant at p<0.25 with the outcome variable in bivariate analysis were selected for multivariable analysis and odds ratio with 95% confidence level was computed and p-value < 0.05 was described as a significant association in multivariable analysis. Result: - Among 421 respondents about 177(42%) had uncontrolled hypertension. Co-morbidity [AOR=0.36, (0.205, 0.631)], five to ten years duration of medication taken [AOR=0.398, (0.218, 0.725)], side effect of medication [AOR=0.542, (0.339, 0.866)] and medication adherence [AOR=4.092, (2.419, 6.924)] were significantly associated with uncontrolled hypertension. Conclusion: - In this study the magnitude of uncontrolled hypertension was high. Co-morbidity, antihypertensive medication taken for long duration, side effect of antihypertensive medication and non adherence to antihypertensive medication shows statistical association with uncontrolled hypertension.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034853
Author(s):  
Niky Ghorbani ◽  
Vivek Muthurangu ◽  
Abbas Khushnood ◽  
Leonid Goubergrits ◽  
Sarah Nordmeyer ◽  
...  

ObjectiveWe aimed to investigate the combined effects of arterial hypertension, bicuspid aortic valve disease (BAVD) and age on the distensibility of the ascending and descending aortas in patients with aortic coarctation.DesignCross-sectional study.SettingThe study was conducted at two university medical centres, located in Berlin and London.ParticipantsA total of 121 patients with aortic coarctation (ages 1–71 years) underwent cardiac MRI, echocardiography and blood pressure measurements.Outcome measuresCross-sectional diameters of the ascending and descending aortas were assessed to compute aortic area distensibility. Findings were compared with age-specific reference values. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology statement and reporting guidelines.ResultsImpaired distensibility (below fifth percentile) was seen in 37% of all patients with coarctation in the ascending aorta and in 43% in the descending aorta. BAVD (43%) and arterial hypertension (72%) were present across all ages. In patients >10 years distensibility impairment of the ascending aorta was predominantly associated with BAVD (OR 3.1, 95% CI 1.33 to 7.22, p=0.009). Distensibility impairment of the descending aorta was predominantly associated with arterial hypertension (OR 2.8, 95% CI 1.08 to 7.2, p=0.033) and was most pronounced in patients with uncontrolled hypertension despite antihypertensive treatment.ConclusionFrom early adolescence on, both arterial hypertension and BAVD have a major impact on aortic distensibility. Their specific effects differ in strength and localisation (descending vs ascending aorta). Moreover, adequate blood pressure control is associated with improved distensibility. These findings could contribute to the understanding of cardiovascular complications and the management of patients with aortic coarctation.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Mekuriaw Mesfin Birhan ◽  
Yekoye Abebe

Background. Hypertension imposes stresses on many organs like heart and kidney. However, studies that show the effect of hypertension on the lungs are limited. Objective. To assess pulmonary function status of hypertensive patients aged 30-64 years at Zewditu Memorial Hospital, 2017. Methods. Hospital based comparative cross-sectional study was conducted on 61 hypertensive patients (cases) and 61 nonhypertensive clients (controls) aged 30-64 years. Computerized spirometry was done in all cases and controls which were selected by systematic sampling technique. The study was conducted from January 20, 2017, to May 25, 2017. Result. The values of FVC, FEV1, and FEF25-75% were 3.52±1.02 liters, 2.97±0.89 liters, and 3.34±1.3 liters/second in hypertensive patients and 4.31±0.82 liters, 3.54±0.7 liters, and 3.94±1.09 liters/second in controls, respectively. These values were significantly lower (p<0.05) in hypertensive patients compared to controls. Restrictive pulmonary defect was dominant in hypertensive patients. FEV1% which was 85%±7% in hypertensive patients and 82%±5% in controls was significantly higher (p<0.05) in hypertensive patients compared to controls. Conclusion. Hypertensive patients exhibit lower pulmonary function values. Routine check-up of the pulmonary function status of such patients should be done to prevent undesired outcomes.


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