Contribution of Ambulatory Blood Pressure Monitoring to the Management of Arterial Hypertension at Blaise Compaoré University Hospital

Abstract

Background: Hypertension is a major public health concern in Burkina Faso. Its management relies on in-office medical setting blood pressure monitoring which is known to be an imperfect diagnosis tool. Objective: This study aims to assess the contribution of ambulatory blood pressure monitoring in the management of hypertension at Blaise Compaoré University Hospital. Methods: A monocentric descriptive retrospective study was conducted in the cardiology outpatient unit of Blaise Compaoré University Hospital. Patients aged at least 18 years who underwent ambulatory blood pressure monitoring between March 2013 and June 2015 were enrolled. Hypertension was defined as follows: average blood pressure over 24 hours > 130/80 mmHg, or diurnal blood pressure > 135/85 mmHg, or nocturnal blood pressure >120/70 mmHg. Data were analyzed using the SPSS 20.0 software. The threshold for significance was set at 5% for a validity interval at 95%. Chi square test was used for the statistical analysis. Results: A total of 122 patients were enrolled. The main reasons for ambulatory monitoring were the evaluation of hypertensive therapy (51.6%) and the diagnosis confirmation (39.3%). The results of the ambulatory monitoring found 61.4% of the patients with hypertension and 37.7% with normal blood pressure. A treatment adjustment was made for 36.1% of the patients; an initiation of antihypertensive therapy was undertaken for 24.6%, an abstention from drug therapy was recommended for 23.8%, and the pursuit of previous treatment for 13.1% of the patients. Conclusion: Ambulatory blood pressure monitoring should be used more often in order to optimize the management of hypertension in our current practice.

Ambulatory blood pressure monitoring and management of hypertension at a cardiac clinic in Kumasi Metropolis, Ghana

“…In another study carried out in an Irish population, 31.7% of patients had a change in their medication, a figure which was lower than that reported in our study where 51.7% of patients had a change in medication prescribed. Also, we observed a higher proportion of patients who had adjustments made in their medications compared to 36.1% reported in a recent publication which included outpatients at a teaching hospital in Benin . Furthermore, a smaller proportion of patients discontinued all medications in our study compared to that reported by Kambiré et al The observed differences may be as a result of differences in population characteristics and thresholds for BP control in different settings.…”

“…Also, we observed a higher proportion of patients who had adjustments made in their medications compared to 36.1% reported in a recent publication which included outpatients at a teaching hospital in Benin . Furthermore, a smaller proportion of patients discontinued all medications in our study compared to that reported by Kambiré et al The observed differences may be as a result of differences in population characteristics and thresholds for BP control in different settings. Additionally, we observed that majority of patients with WUCH were either maintained on previously prescribed treatment or therapy deintensified when the clinician interpreted the ABPM report.…”