Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka

Anqi Zhu; Truls Ostbye; Aliya Naheed; H. Asita de Silva; Imtiaz Jehan; Mihir Gandhi; Nantu Chakma; Anuradhani Kasturiratne; Zainab Samad; Tazeen Hasan Jafar

doi:10.1111/jch.14787

Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka

Anqi Zhu
, Truls Ostbye
, Aliya Naheed
, H. Asita de Silva
, Imtiaz Jehan
, Mihir Gandhi
, Nantu Chakma
, Anuradhani Kasturiratne
, Zainab Samad
, Tazeen Hasan Jafar^*

^*Tämän työn vastaava kirjoittaja

Aistit ja neuroalat, syövänhoito, kirurgia

Tutkimustuotos: Artikkeli › Tieteellinen › vertaisarvioitu

1 Sitaatiot (Scopus)

14 Lataukset (Pure)

Abstrakti

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.

Alkuperäiskieli	Englanti
Sivut	391-404
Sivumäärä	14
Julkaisu	Journal of Clinical Hypertension
Vuosikerta	26
Numero	4
Varhainen verkossa julkaisun päivämäärä	2024
DOI - pysyväislinkit	https://doi.org/10.1111/jch.14787
Tila	Julkaistu - huhtik. 2024
OKM-julkaisutyyppi	A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Rahoitus

We would like to thank all the investigators and research teams who conducted the COBRA‐BPS trial, including the International Center for Diarrheal Disease Research, Bangladesh (Dhaka); Aga Khan University (Karachi, Pakistan); the Faculty of Medicine, University of Kelaniya (Ragama, Sri Lanka); the London School of Hygiene and Tropical Medicine (London); and Duke‐NUS Medical School (Singapore, Singapore). We are deeply thankful to the trial participants for their voluntary participation and contribution to the study findings. We also acknowledge the contributions of the trial steering committee and the data coordinating center for their efforts in the collection and management of the trial data. This work is supported by the Joint Global Health Trials Scheme (MR/N006178/1) of the UK Foreign, Commonwealth & Development Office (FCDO), the Medical Research Council, the Wellcome Trust, and the National Institute for Health Research.

Rahoittajat
UK Foreign, Commonwealth and Development office
Wellcome Trust
Medical Research Council
National Institute for Health and Care Research
UK Foreign, Commonwealth and Development office

YK:n kestävän kehityksen tavoitteet

Tämä tuotos edistää seuraavia kestävän kehityksen tavoitteita:

SDG 3 – Hyvä terveys ja hyvinvointi

Julkaisufoorumi-taso

Jufo-taso 1

!!ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Cardiology and Cardiovascular Medicine

Pääsy asiakirjaan

10.1111/jch.14787Lisenssi: CC BY

J of Clinical Hypertension - 2024 - Zhu - Ambulatory blood pressure levels in individuals with uncontrolled clinic-1Final published version, 319 KBLisenssi: CC BY

https://urn.fi/URN:NBN:fi:tuni-202403273124Lisenssi: CC BY

Siteeraa tätä

@article{85da302468d949b695f4533c4af9cbea,

title = "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, 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.",

keywords = "ambulatory blood pressure monitor, South Asia, uncontrolled clinic hypertension",

author = "Anqi Zhu and Truls Ostbye and Aliya Naheed and \{de Silva\}, \{H. Asita\} and Imtiaz Jehan and Mihir Gandhi and Nantu Chakma and Anuradhani Kasturiratne and Zainab Samad and Jafar, \{Tazeen Hasan\}",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.",

year = "2024",

month = apr,

doi = "10.1111/jch.14787",

language = "English",

volume = "26",

pages = "391--404",

journal = "Journal of Clinical Hypertension",

issn = "1524-6175",

publisher = "Wiley-Blackwell",

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TY - JOUR

T1 - Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka

AU - Zhu, Anqi

AU - Ostbye, Truls

AU - Naheed, Aliya

AU - de Silva, H. Asita

AU - Jehan, Imtiaz

AU - Gandhi, Mihir

AU - Chakma, Nantu

AU - Kasturiratne, Anuradhani

AU - Samad, Zainab

AU - Jafar, Tazeen Hasan

PY - 2024/4

Y1 - 2024/4

N2 - 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.

AB - 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.

KW - ambulatory blood pressure monitor

KW - South Asia

KW - uncontrolled clinic hypertension

U2 - 10.1111/jch.14787

DO - 10.1111/jch.14787

M3 - Article

AN - SCOPUS:85186865413

SN - 1524-6175

VL - 26

SP - 391

EP - 404

JO - Journal of Clinical Hypertension

JF - Journal of Clinical Hypertension

IS - 4

ER -

Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka

Abstrakti

Rahoitus

YK:n kestävän kehityksen tavoitteet

Julkaisufoorumi-taso

!!ASJC Scopus subject areas

Pääsy asiakirjaan

Sormenjälki

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