Role of Ambulatory Blood Pressure Monitoring in Chronic Hypertensive Patients on Antihypertensive Therapy-A Cross-sectional Study

Abstract

Introduction: Regular monitoring of blood pressure in chronic hypertensive patients on antihypertensive therapy is essential to assess cardiovascular events and to prevant target organ damage. Aim: The present study was undertaken as an attempt to correlate the relation between random blood pressure monitoring and 24 hour Ambulatory blood pressure monitoring in chronic hypertensive patients on therapy and to assess the efficacy of antihypertensive medication in chronic hypertensive patients. Materials and Methods: The study was undertaken as a prospective cross-sectional study among 100 patients during the period of June 2015 to June 2016 using convenient sampling technique. As per Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High blood Pressure (JNC 7) guidelines, cases of diagnosed hypertension on regular medication and on follow-up in the outpatient department of General Medicine in a tertiary care hospital were included in the study. Blood pressure was recorded using a mercury sphygmomanometer or aneroid or electronic device as per JNC guidelines. After that Ambulatory Blood Pressure Monitoring (ABPM) device was attached on a belt connected to a standard cuff in the upper arm which uses an oscillometry technique to detect systolic, diastolic and Mean Arterial Blood Pressure (MAP). Descriptive statistics was expressed by means and proportions. Paired t-test was used to find statistically significant difference in related sample observations. A p-value <0.05 was considered statistically significant. Results: Majority of the study participants were males and were in the age group of 31-40 years. There was a significant difference between random (clinic) blood pressure and ambulatory blood pressure recordings. It was observed that 36 patients (36%) were dippers, 54 patients (54%) were nondippers, 10 patients (10%) were reverse dippers independent of clinical blood pressure readings. Conclusion: Ambulatory blood pressure monitoring gives a true estimate of 24 hour readings rather than a single clinic blood pressure which can be influenced by so many factors. It also gives an estimate of other variables like morning surge and nocturnal dip.

Keywords

• cardiovascular events
• dippers
• systolic blood pressure
• target organ damage