Main features of the ambulatory blood pressure monitoring in the non-controlled essential hypertension patients

Abstract

The problem of blood pressure (BP) effective control in Ukrainians is still relevant. Ambulatory blood pressure monitoring (ABPM) is a modern method of BP investigation. However, only some ABPM parameters, as diurnal systolic BP (SBP) and diastolic BP (DBP), now use as the diagnostic guide according to international recommendations.Aim. To determine peculiarities of ABPM parameters in treated uncontrolled hypertensive patients.Materials and methods. We investigated 153 patients with essential hypertension and divided two groups according to the level of 24-h SBP and 24-h DBP. There were 103 patients who have uncontrolled levels of BP in the first group and 50 patients with normotensive individuals in the second group.Results. We had a significant increase of SBP (21,8%; р=0,001), DBP (21,5%; р=0,001), pulse BP (PBP) (22,8%; р=0,001) and the morning surge in SBP (20,7%; р=0,004) in the first group versus the second group. Furthermore, there was a considerable rise in such parameters, like the square of hypertension of diurnal SBP in 9,2 times (р=0,001), daily in 9,5 times (р=0,001), nocturnal in 8,6 times (р=0,001); index of the square of diurnal DBP reduction in 7,2 times (р=0,001), daily in 8,1 times (р=0,001) and nocturnal in 5,7 times (р=0,001) in the first group than in the second group. There was no significant difference in index of night reduce of SBP, speed of morning rise of SBP and DBP, ambulatory arterial stiffness index (AASI) and symmetric slope index (sym_AASI).Conclusion. This study shows that treated non-controlled hypertensive patients have 20-25% increase in diurnal SBP, DBP and PBP. There is a night-fold increase in diurnal index of SBP square hypertension and a DPB seven-fold increase in diurnal index of square hypertension. There is no statistical significance in index of night reduce of SBP, speed of morning rise of SBP and DBP, AASI and sym_AASI.