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.