Evaluating blood pressure variability in hypertensive patients with comorbidities: a prospective observational study using 24-hour ambulatory blood pressure monitoring

Manjree Dube; Sunil R. Dube; Stuti Dube; Bappanad Aishwarya Narasimhan

doi:10.18203/2319-2003.ijbcp20254157

Authors

Manjree Dube Department of Physiology, D Y Patil Deemed to be University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India https://orcid.org/0009-0002-9102-5643
Sunil R. Dube Department of Medicine, Terna Medical College & Hospital, Address: Sector No. 12, Phase No. – II, Nerul Navi Mumbai, Maharashtra, India
Stuti Dube D. Y. Patil Deemed to be University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India https://orcid.org/0009-0000-6466-7574
Bappanad Aishwarya Narasimhan Department of Rheumatology, Fortis Hospital, Mulund, Mumbai, Maharashtra, India https://orcid.org/0009-0001-0993-3873

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20254157

Keywords:

Blood pressure variability, Ambulatory blood pressure monitoring, Hypertension, Diabetes mellitus, Antihypertensive therapy, Gender differences, Cardiovascular risk

Abstract

Background: Blood pressure variability (BPV) is an independent predictor of cardiovascular risk, particularly in patients with hypertension and diabetes. This study aimed to evaluate BPV in hypertensive patients with comorbidities using ambulatory blood pressure monitoring (ABPM) and assess the influence of gender and antihypertensive therapy.

Methods: This prospective observational study included 58 patients (aged 26–85 years) undergoing 24-hour ABPM in Mumbai, India. BPV was assessed using the standard deviation of 24-hour systolic blood pressure (SD 24-h SBP). Patients were categorized based on hypertension and diabetes status, gender, and antihypertensive therapy (monotherapy, dual, or triple therapy). Statistical comparisons were made using t-tests and chi-square tests, with significance set at p<0.05.

Results: Patients with diabetes exhibited significantly higher BPV than those without diabetes (p<0.05). Gender differences were observed, with females showing greater BPV than males. Among hypertensive patients, those on triple therapy had higher BPV than those on dual therapy, indicating greater difficulty in achieving BP control. Despite antihypertensive and adjunct therapies, BPV remained elevated in some patients, particularly those with diabetes and those requiring multiple antihypertensive agents.

Conclusions: BPV is significantly elevated in patients with diabetes and those on intensive antihypertensive regimens, highlighting the challenges in BP management. The observed gender differences suggest potential influences of hormonal and vascular factors. These findings underscore the need for personalized treatment strategies to improve BP control and reduce cardiovascular risk in high-risk populations.

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Author Biographies

Stuti Dube, D. Y. Patil Deemed to be University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India

MBBS Student, D Y Patil Deemed to be University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India

Bappanad Aishwarya Narasimhan, Department of Rheumatology, Fortis Hospital, Mulund, Mumbai, Maharashtra, India

Emergency Physician, Mumbai, India

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