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Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus
OBJECTIVE: To identify the determinants of systolic blood pressure variability (SBPV) among Ghanaians. DESIGN: We undertook a secondary analysis of data collected in a prospective study SETTING: The study involved patients with hypertension and or diabetes receiving care in five hospitals in Ghana M...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Ghana Medical Association
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416271/ https://www.ncbi.nlm.nih.gov/pubmed/37576371 http://dx.doi.org/10.4314/gmj.v57i1.5 |
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author | Sarfo, Fred S Ayisi-Boateng, Nana K Nguah, Samuel B Sarfo-Kantanka, Osei Kokuro, Collins Ababio, Hanson Adu-Boakye, Yaw Ovbiagele, Bruce |
author_facet | Sarfo, Fred S Ayisi-Boateng, Nana K Nguah, Samuel B Sarfo-Kantanka, Osei Kokuro, Collins Ababio, Hanson Adu-Boakye, Yaw Ovbiagele, Bruce |
author_sort | Sarfo, Fred S |
collection | PubMed |
description | OBJECTIVE: To identify the determinants of systolic blood pressure variability (SBPV) among Ghanaians. DESIGN: We undertook a secondary analysis of data collected in a prospective study SETTING: The study involved patients with hypertension and or diabetes receiving care in five hospitals in Ghana MAIN OUTCOME MEASURES: We assessed determinants of SBPV among 2,785 Ghanaian patients. We calculated the standard deviation (SD) of systolic BP recordings of 3 to 10 visits per patient over 18 months as a measure of SBPV. A multivariate linear regression analysis was fitted to identify factors independently associated with risk visit-to-visit SBP standard deviation. RESULTS: The mean SD of individual patient visit-to-visit SBP overall was 14.8± 6.3 mm Hg. Those with hypertension and diabetes had the highest SD of 15.4 ±6.2 mm Hg followed by 15.2 ±6.5 mm Hg among those with hypertension only and then 12.0 ± 5.2 mm Hg among those with diabetes only, p<0.0001. Factors independently associated with SBPV with adjusted β coefficients (95% CI) included age: 0.06 (0.03 – 0.08) for each year rise in age, eGFR -0.03 (-0.05 - -0.02) for each ml/min rise, low monthly income of <210 Ghana cedis 1.45 (0.43-2.46), and secondary level of education -1.10 (-1.69, -0.50). Antihypertensive classes were associated with SBPV, the strongest associations being hydralazine 2.35 (0.03 – 4.68) and Methyldopa 3.08 (2.39 – 3.77). CONCLUSION: Several socio-demographic and clinical factors are associated with SBPV. Future studies should assess the contribution of SBPV to CVD outcomes among indigenous Africans and identify actionable targets. FUNDING: Funding for this study was provided by MSD, Novartis, Pfizer, Sanofi (each a Participant Company) and the Bill and Melinda Gates Foundation (collectively, the Funders) through the New Venture Fund (NVF). FSS and BO are also supported by funding from the National Heart, Lung, and Blood Institute (R01HL152188). |
format | Online Article Text |
id | pubmed-10416271 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Ghana Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-104162712023-08-12 Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus Sarfo, Fred S Ayisi-Boateng, Nana K Nguah, Samuel B Sarfo-Kantanka, Osei Kokuro, Collins Ababio, Hanson Adu-Boakye, Yaw Ovbiagele, Bruce Ghana Med J Original Article OBJECTIVE: To identify the determinants of systolic blood pressure variability (SBPV) among Ghanaians. DESIGN: We undertook a secondary analysis of data collected in a prospective study SETTING: The study involved patients with hypertension and or diabetes receiving care in five hospitals in Ghana MAIN OUTCOME MEASURES: We assessed determinants of SBPV among 2,785 Ghanaian patients. We calculated the standard deviation (SD) of systolic BP recordings of 3 to 10 visits per patient over 18 months as a measure of SBPV. A multivariate linear regression analysis was fitted to identify factors independently associated with risk visit-to-visit SBP standard deviation. RESULTS: The mean SD of individual patient visit-to-visit SBP overall was 14.8± 6.3 mm Hg. Those with hypertension and diabetes had the highest SD of 15.4 ±6.2 mm Hg followed by 15.2 ±6.5 mm Hg among those with hypertension only and then 12.0 ± 5.2 mm Hg among those with diabetes only, p<0.0001. Factors independently associated with SBPV with adjusted β coefficients (95% CI) included age: 0.06 (0.03 – 0.08) for each year rise in age, eGFR -0.03 (-0.05 - -0.02) for each ml/min rise, low monthly income of <210 Ghana cedis 1.45 (0.43-2.46), and secondary level of education -1.10 (-1.69, -0.50). Antihypertensive classes were associated with SBPV, the strongest associations being hydralazine 2.35 (0.03 – 4.68) and Methyldopa 3.08 (2.39 – 3.77). CONCLUSION: Several socio-demographic and clinical factors are associated with SBPV. Future studies should assess the contribution of SBPV to CVD outcomes among indigenous Africans and identify actionable targets. FUNDING: Funding for this study was provided by MSD, Novartis, Pfizer, Sanofi (each a Participant Company) and the Bill and Melinda Gates Foundation (collectively, the Funders) through the New Venture Fund (NVF). FSS and BO are also supported by funding from the National Heart, Lung, and Blood Institute (R01HL152188). Ghana Medical Association 2023-01 /pmc/articles/PMC10416271/ /pubmed/37576371 http://dx.doi.org/10.4314/gmj.v57i1.5 Text en Copyright © The Author(s). https://creativecommons.org/licenses/by/4.0/This is an Open Access article under the CC BY license. |
spellingShingle | Original Article Sarfo, Fred S Ayisi-Boateng, Nana K Nguah, Samuel B Sarfo-Kantanka, Osei Kokuro, Collins Ababio, Hanson Adu-Boakye, Yaw Ovbiagele, Bruce Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus |
title | Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus |
title_full | Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus |
title_fullStr | Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus |
title_full_unstemmed | Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus |
title_short | Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus |
title_sort | determinants of visit-to-visit systolic blood pressure variability among ghanaians with hypertension and diabetes mellitus |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416271/ https://www.ncbi.nlm.nih.gov/pubmed/37576371 http://dx.doi.org/10.4314/gmj.v57i1.5 |
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