DETERMINANTS OF SUBOPTIMAL BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS: ۲۴-HOUR AMBULATORY BLOOD PRES-SURE MONITORING

Abstract    INTRODUCTION: The study was conducted to define the determinants of suboptimal blood pressure (BP) control among hypertensive patients under treatment and explore a predictive model for detecting the patients at risk for increased BP.    METHODS: We enrolled ۹۷ patients (۴۰ males, ۵۷ females) under treatment for hypertension between June ۲۰۰۶ and May ۲۰۰۷ in Shafa hospital, Kerman, Iran. BP was measured at clinic twice within ۵-minute intervals. After setting up ambulatory blood pressure monitoring (ABPM), BP was measured at ۳۰-minute intervals during the day and ۶۰-minute intervals during the night. The frequency of increased BP (more than ۱۴۰/۹۰ mmHg) was included in a regression model as dependent variable and all the others such as age, sex, body mass index (BMI), drugs and baseline clinical measurements as the predictors.    RESULTS: Increased BP was detected in ۴۴% (۹۵% CI: ۳۸.۷۹%-۴۹.۶۵%) of all measurements during ۲۴-hour monitoring. The frequency of increased BP had a significant relationship with BMI (b=۰.۳۵, P=۰.۰۰۱). Clinic's pulse pressure was a significant predicting factor for BP increase (P=۰.۰۲).    CONCLUSION: BMI and pulse pressure are the best predictors for being hypertensive during lifetime. Ineffective treatment of hypertension is frequent among the hypertensive patients.      Keywords: Blood pressure control, Pulse pressure, Ambulatory blood pressure monitoring (ABPM), BMI.