Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese...Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2</sup> = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.展开更多
AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National...AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio(ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1 DM patients and 20 matched controls. T1 DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure(BP) and renal function according to the general referencepopulation. Non-diabetic controls were adolescents of general population matched for sex, age and BMI.RESULTS Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) were respectively 116 ± 9 mm Hg in the diabetic group vs 111 ± 8 mm Hg in the nondiabetic(P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg(P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls(SBP: 118 ± 10 mm Hg vs 114 ± 10 mm Hg, P = 0.11; DBP: 71 ± 7 mm Hg vs 68 ± 6 mm Hg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP(112 ± 11 mm Hg vs 106 ± 7 mm Hg, P = 0.06) and to the mean arterial pressure(MAP)(89 ± 9 mm Hg vs 81 ± 6 mm Hg, P = 0.06). ACR at rest was similar in both groups(5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise(10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria(116 ± 10 mm Hg vs 108 ± 10 mm Hg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1 DM.展开更多
AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-s...AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill exercise.RESULTSWe enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting albuminuria.CONCLUSIONExercise induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.展开更多
文摘Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2</sup> = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.
文摘AIM To investigated the relationship between exerciseinduced ambulatory blood pressure measurement(ABPM) abnormalities in type 1 diabetes mellitus(T1DM) adolescents. METHODS We conducted a case-control at the National Obesity Center of the Yaoundé Central Hospital, Cameroon. We compared 24 h ABPM and urinary albumin-to-creatinine ratio(ACR) at rest and after a standardized treadmill exercise between 20 Cameroonian T1 DM patients and 20 matched controls. T1 DM adolescents were aged 12-18 years, with diabetes for at least one year, without proteinuria, with normal office blood pressure(BP) and renal function according to the general referencepopulation. Non-diabetic controls were adolescents of general population matched for sex, age and BMI.RESULTS Mean duration of diabetes was 4.2 ± 2.8 years. The mean 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) were respectively 116 ± 9 mm Hg in the diabetic group vs 111 ± 8 mm Hg in the nondiabetic(P = 0.06), and 69 ± 7 mm Hg vs 66 ± 5 mm Hg(P = 0.19). There was no difference in the diurnal pattern of BP in diabetes patients and non-diabetic controls(SBP: 118 ± 10 mm Hg vs 114 ± 10 mm Hg, P = 0.11; DBP: 71 ± 7 mm Hg vs 68 ± 6 mm Hg, P = 0.22). Nighttime BP was higher in the diabetic group with respect to SBP(112 ± 11 mm Hg vs 106 ± 7 mm Hg, P = 0.06) and to the mean arterial pressure(MAP)(89 ± 9 mm Hg vs 81 ± 6 mm Hg, P = 0.06). ACR at rest was similar in both groups(5.5 mg/g vs 5.5 mg/g, P = 0.74), but significantly higher in diabetes patients after exercise(10.5 mg/g vs 5.5 mg/g, P = 0.03). SBP was higher in patients having exercise-induced albuminuria(116 ± 10 mm Hg vs 108 ± 10 mm Hg, P = 0.09). CONCLUSION Exercise-induced albuminuria could be useful for early diagnosis of kidney damage in adolescents with T1 DM.
文摘AIMTo investigate the relationship between circadian vari-ations in blood pressure （BP） and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes （T2D） patients.METHODSWe conducted a cross-sectional study in well controlled T2D patients, non-hypertensive, without clinical pro-teinuria and normal creatinine clearance. In each parti-cipant, we recorded the BP using ambulatory bloodTankeu AT et al . Exercise-induced albuminuria and BP in T2DMpressure monitoring （ABPM） for 24-h, and albuminuria at rest and after a standardized treadmill exercise.RESULTSWe enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure （SBP） of 128 ± 17 mmHg vs nocturnal of 123 ± 19 mmHg （ P = 0.004）, and mean diurnal diastolic blood pressure （DBP） of 83 ± 11 mmHg vs nocturnal 78 ± 14 mmHg （ P = 0.002）. There was a signifcant difference between albuminuria at rest [median = 23 mg, interquartile range （IQR） = 10-51] and after exercise （median = 35 mg, IQR = 23-80, P 〈 0.001）. Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components （128 mmHg vs 110 mmHg, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure）, as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP （83 vs 86, P = 0.03） than resting albuminuria.CONCLUSIONExercise induced albuminuria is associated with anincrease in nocturnal BP values in T2D patients.
