Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka

• DOI: 10.1111/jch.14787
• Publication Date: 2024-03-07T11:54:19Z
• Authors: Anqi Zhu; Truls Ostbye; Aliya Naheed; H Asita de Silva; Imtiaz Jehan; Mihir Gandhi; Nantu Chakma; Anuradhani Kastur...; Zainab Samad; Tazeen Hasan Jafar
• Keywords: History; Critical Care; Population; Cardiology; 610; Blood Pressure; 613; South Asia; Pediatrics; 3121; 03 medical and health sciences; 0302 clinical medicine; Ambulatory blood pressure monitor; Health Sciences; Ambulatory; Diseases of the circulatory (Cardiovascular) system; Diagnosis and Management of Syncope; Internal medicine; Uncontrolled clinic hypertension; Sri lanka; Management of Hypertension and Cardiovascular Risk Factors; Original Articles; Ambulatory blood pressure; ambulatory blood pressure monitor; Environmental health; RC666-701; Analysis and Applications of Heart Rate Variability; uncontrolled clinic hypertension; Hypertension; Emergency Medicine; Blood pressure; Medicine; Emergency medicine; Surgery; South asia; Cardiology and Cardiovascular Medicine; Ethnology

AbstractHypertension is a leading risk factor for cardiovascular disease in South Asia. The authors aimed to assess the cross‐country differences in 24‐h ambulatory, daytime, and nighttime systolic blood pressure (SBP) among rural population with uncontrolled clinic hypertension in Bangladesh, Pakistan, and Sri Lanka. The authors studied patients with uncontrolled clinic hypertension (clinic BP ≥ 140/90 mmHg) who underwent ambulatory blood pressure monitoring (ABPM) during the baseline assessment as part of a community‐based trial. The authors compared the distribution of ABPM profiles of patients across the three countries, specifically evaluating ambulatory SBP levels with multivariable models that adjusted for patient characteristics. Among the 382 patients (mean age, 58.3 years; 64.7% women), 56.5% exhibited ambulatory hypertension (24‐h ambulatory BP ≥ 130/80 mmHg), with wide variation across countries: 72.6% (Bangladesh), 50.0% (Pakistan), and 51.0% (Sri Lanka; P < .05). Compared to Sri Lanka, adjusted mean 24‐h ambulatory, daytime, and nighttime SBP were higher by 12.24 mmHg (95% CI 4.28–20.20), 11.96 mmHg (3.87–20.06), and 12.76 mmHg (4.51–21.01) in Bangladesh, separately. However, no significant differences were observed between Pakistan and Sri Lanka (P > .05). Additionally, clinic SBP was significantly associated with 24‐h ambulatory (mean 0.38, 95% CI 0.28–0.47), daytime (0.37, 0.27–0.47), and nighttime SBP (0.40, 0.29–0.50) per 1 mmHg increase. The authors observed substantial cross‐country differences in the distribution of ABPM profiles among patients with uncontrolled clinic hypertension in rural South Asia. The authors findings indicated the need to incorporate 24‐h BP monitoring to mitigate cardiovascular risk, particularly in Bangladesh.