0164 : Contribution of ambulatory blood pressure in the therapeutic management of hypertension

Autor: Salim Arous, Abdelaziz Hadadi, Hafdi Karim, Rachida Habbal
Rok vydání: 2016
Předmět:
Zdroj: Archives of Cardiovascular Diseases Supplements. 8(3)
ISSN: 1878-6480
DOI: 10.1016/s1878-6480(16)30478-5
Popis: Introduction Hypertension is a major cardiovascular risk factor associated with significant morbidity and mortality. Because of the risk of white coat effect which increases the blood pressure in the office, the ambulatory blood pressure (ABPM) is a good tool to assess the blood pressure profile of the patient, adapting its treatment and establish its prognosis. Objects assess the impact of ABPM in the therapeutic management of hypertensive patients diagnosed and treated. Methods Retrospective study spread over 1 year (May 2014-May 2015), analyzing 202 patients of the ABPM register of cardiology department (UH Ibn Rochd of Casablanca) for therapeutic evaluation. Results The average age of the study population was 59 years (26-97 years). 59% of patients in our study were women, with a sex ratio at 0.69. Age and obesity are the most common risk factors (43%), followed by diabetes found in 27% and tobacco in 13%. The analysis of 202 ABPM performed in treated hypertensive patients allowed to retain the following: - The effect of “white coat” was found in 56% of patients who should avoid unnecessary therapeutic escalation. - 51% of patients experienced a nocturnal hypertension. - About half of patients do not lower their blood pressure at night despite treatment. 10% have increased contrary to their nocturnal pressure. - 4% of patients were considered extreme dippers. - Finally, about 9% of patients in our population that are considered hypertensive patients resistant to treatment, the ABPM was diagnosed a white coat effect in half of these patients (5% prevalence of true resistant hypertension). Conclusion The MAPA is an invaluable tool for the management of hypertensive patients under treatment. This work encourages us to reflect on the definition of perfect control of blood pressure which, in our view, should not only normalize daytime blood pressure but also restore the circadian rhythm. The author hereby declares no conflict of interest
Databáze: OpenAIRE
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