OBJECTIVES

There are limited data on the management of hypertension (HT) in Algeria. The lack of local guidelines might lead to variations in diagnosis, treatment and control of HT between physicians. Ambulatory blood pressure measurement (ABPM) is useful in guiding therapeutic and clinical decisions. We aimed to review the contribution of ABPM for the diagnosis and management of HT in Algeria.

METHODS

A prospective, observational, multicenter study, designed to include 1065 patients has been initiated in June 2017. Patients aged ≥ 18 years with suspected (SHT) or treated HT (THT) were included. HT was defined according to international guidelines at the time of study initiation (BP≥140/90 mmHg). A 24-hour ABPM was performed at baseline (V1) in all patients. Therapeutic decision was taken according to ABPM results at V2. Treated patients were then followed up to 6 weeks (V3).

RESULTS

This final analysis included 1027 patients. They were mostly aged 40-60 years (52.5%) and mainly females (61.6%). They were 37.3% (58.2% females) with a THT since 6.9 years in average and 62.7% with SHT (63.7% females). Major factors associated with HT were diabetes (15.7%) and dyslipidemia (7.2%). ABPM confirmed HT in 60.8% of SHT patients and detected uncontrolled HT in 55.1% of THT patients. Antihypertensive therapy was initiated at V2 in 88.9% of SHT group and a therapeutic adjustment or a switch was performed in 65.4% of THT patients. Therapeutic strategy was mainly based on monotherapy regimen in 36% of THT and in 69% of SHT patients. These monotherapies consisted in diuretics (40%) and angiotensin II receptor antagonists (46%) in THT and SHT groups, respectively. The same findings were observed 6 weeks later.

CONCLUSIONS

Our results confirm that ABPM is a highly valuable method in diagnosing and ad confirming hypertension, as well as in guiding and assessing antihypertensive therapy.