Blood Pressure in Patients with Arterial Hypertension and Overweight or Obesity During Office Measurement and Daily Monitoring

Abstract

Arterial hypertension (AH) is one of the most common chronic diseases in the world. More than 1.5 billion people suffer from hypertension. According to official statistics, in Ukraine in 2021 more than 13 million patients with AH were registered, and annually this disease is detected in 1 million Ukrainians. The objective: to determine the levels of blood pressure (BP) in overweighted or obese patients with AH who use antihypertensive drugs during office measurement and 24-hours monitoring of BP. Materials and methods. The study analyzed the results of treatment of 395 overweighted or obese patients (139 women and 236 men) with essential AH. All patients received antihypertensive treatment for at least 3 months before study start. Patients were divided into five groups depending on blood pressure. The control group included 33 age-matched individuals. During the study BP was measured in physician’s office with use of mechanical tonometer with a shoulder cuff and ambulatory 24-hours blood pressure monitoring (ABPM) was performed for all patients. Results. The results of office blood pressure measurement and ABPM were analyzed. Normal BP was detected in 34.7% of patients with AH and high BMI. In 10.9% of patients systolic blood pressure (SBP) remains above 139 mm Hg despite of drug use, in 16.3% of patients the grade 1 AH was diagnosed, in 23.2% – grade 2, and in 14.9% – grade 3 AH was deter mined during office blood pressure measurement. It was found that men are 1.7 times more likely had uncontrolled AH comparing to women. The further analyze of the BP data showed that office BP levels were higher then home. Target blood pressure levels were found in 87% of patients during ABPM, although in the office measurement this figure was 54%, 5% of patients could not withstand the BP monitoring during the day with an automatic device due to pain. No difference in heart rate was determined in study patients by different types of measurement. Conclusions. In patients with AH and high body mass index, office measurement reveals insufficient reduction of blood pressure (BP) in 35% of patients despite of antihypertensive drugs use. At the same time ABPM found target BP achievement in 87% of patients. Thus, ABPM should be performed in overweighted or obese patients with AH before making the decision to increase the antihypertensive drug dose to avoid possible undesirable BP decrease.