Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka
Abstract Hypertension 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, Paki...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-04-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14787 |
| _version_ | 1797214412809961472 |
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| author | Anqi Zhu Truls Ostbye Aliya Naheed H Asita deSilva Imtiaz Jehan Mihir Gandhi Nantu Chakma Anuradhani Kasturiratne Zainab Samad Tazeen Hasan Jafar |
| author_facet | Anqi Zhu Truls Ostbye Aliya Naheed H Asita deSilva Imtiaz Jehan Mihir Gandhi Nantu Chakma Anuradhani Kasturiratne Zainab Samad Tazeen Hasan Jafar |
| author_sort | Anqi Zhu |
| collection | DOAJ |
| description | Abstract Hypertension 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. |
| first_indexed | 2024-04-24T11:13:46Z |
| format | Article |
| id | doaj.art-3fb06300399245e6be4b97cf5e5d41b5 |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-04-24T11:13:46Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-3fb06300399245e6be4b97cf5e5d41b52024-04-11T11:01:33ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762024-04-0126439140410.1111/jch.14787Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri LankaAnqi Zhu0Truls Ostbye1Aliya Naheed2H Asita deSilva3Imtiaz Jehan4Mihir Gandhi5Nantu Chakma6Anuradhani Kasturiratne7Zainab Samad8Tazeen Hasan Jafar9Program in Health Services & Systems Research Duke‐NUS Medical School Singapore SingaporeDuke University Department of Family Medicine and Community Health Duke University Medical Center Durham North Carolina USAHealth Systems and Population Studies Division International Centre for Diarrhoeal Disease Research (ICDDR, B) Dhaka BangladeshDepartment of Pharmacology Faculty of Medicine University of Kelaniya Ragama Sri LankaDepartment of Community Health Science Aga Khan University Karachi PakistanBiostatisticsSingapore Clinical Research InstituteSingapore SingaporeHealth Systems and Population Studies Division International Centre for Diarrhoeal Disease Research (ICDDR, B) Dhaka BangladeshDepartment of Public Health Faculty of Medicine University of Kelaniya Ragama Sri LankaDepartment of Medicine Medical College Aga Khan University Karachi PakistanProgram in Health Services & Systems Research Duke‐NUS Medical School Singapore SingaporeAbstract Hypertension 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.https://doi.org/10.1111/jch.14787ambulatory blood pressure monitorSouth Asiauncontrolled clinic hypertension |
| spellingShingle | Anqi Zhu Truls Ostbye Aliya Naheed H Asita deSilva Imtiaz Jehan Mihir Gandhi Nantu Chakma Anuradhani Kasturiratne Zainab Samad Tazeen Hasan Jafar Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka The Journal of Clinical Hypertension ambulatory blood pressure monitor South Asia uncontrolled clinic hypertension |
| title | Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka |
| title_full | Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka |
| title_fullStr | Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka |
| title_full_unstemmed | Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka |
| title_short | Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka |
| title_sort | ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across bangladesh pakistan and sri lanka |
| topic | ambulatory blood pressure monitor South Asia uncontrolled clinic hypertension |
| url | https://doi.org/10.1111/jch.14787 |
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