Prognostic value of ambulatory blood pressure monitoring in treated hypertensive patients.

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.