Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania

Abstract

Background Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania. Aim To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees. Methods A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson’s correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. P -value of <0.05 was considered statistically significant. Results In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01. Conclusion Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.

The correlation between ambulatory blood pressure parameters and cardiovascular risk factors in older adults with high-risk hypertension

“…Regarding 24-hour mean diastolic BP, we found significant correlations with BMI and prior stroke, consistent with previous research [13,16]. The inverse relationship between diastolic BP and cardiovascular risk, particularly coronary heart disease, was well-established [17,18].…”

“…Chuwa et al conducted a study in Tanzania, involving university employees, and reported similar correlations, except for family history of hypertension [13]. Furthermore, the prevalence of dyslipidemia in our study population was consistent with previous findings, supporting the correlation between dyslipidemia and elevated BP [13]. These results indicate the relevance of considering these factors in assessing an individual's BP and cardiovascular risks.…”

“…The significant correlations observed between 24-hour mean SBP and various factors, including age, BMI, waist circumference, creatinine level, dyslipidemia, and family history of hypertension, align with previous studies [13 -15]. Chuwa et al conducted a study in Tanzania, involving university employees, and reported similar correlations, except for family history of hypertension [13]. Furthermore, the prevalence of dyslipidemia in our study population was consistent with previous findings, supporting the correlation between dyslipidemia and elevated BP [13].…”

Obesity in Hypertensive Patients Is Characterized by a Dawn Phenomenon in Systolic Blood Pressure Values and Variability

“…Twenty-four-hour ambulatory blood pressure monitoring (ABPM) provides information about the blood pressure profile and its variability, unlike office measurements. ABPM parameters (including daytime and nighttime systolic blood pressure (SBP), diastolic blood pressure (DBP), standard deviation, and dipping status) correlate more strongly with the risk of cardiovascular diseases and cardiovascular death than office blood pressure [3][4][5][6][7][8]. ABPM allows for the evaluation of short-term blood pressure variability.…”