Publication:

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

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.