Back to Search
Start Over
An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes.
- Source :
-
The Pan African medical journal [Pan Afr Med J] 2014 Oct 31; Vol. 19, pp. 231. Date of Electronic Publication: 2014 Oct 31 (Print Publication: 2014). - Publication Year :
- 2014
-
Abstract
- Introduction: Ambulatory blood pressure (BP) measurements (ABPM) predict health outcomes better than office BP, and are recommended for assessing BP control, particularly in high-risk patients. We assessed the performance of office BP in predicting optimal ambulatory BP control in sub-Saharan Africans with type 2 diabetes (T2DM).<br />Methods: Participants were a random sample of 51 T2DM patients (25 men) drug-treated for hypertension, receiving care in a referral diabetes clinic in Yaounde, Cameroon. A quality control group included 46 non-diabetic individuals with hypertension. Targets for BP control were systolic (and diastolic) BP.<br />Results: Mean age of diabetic participants was 60 years (standard deviation: 10) and median duration of diabetes was 6 years (min-max: 0-29). Correlation coefficients between each office-based variable and the 24-h ABPM equivalent (diabetic vs. non-diabetic participants) were 0.571 and 0.601 for systolic (SBP), 0.520 and 0.539 for diastolic (DBP), 0.631 and 0.549 for pulse pressure (PP), and 0.522 and 0.583 for mean arterial pressure (MAP). The c-statistic for the prediction of optimal ambulatory control from office-BP in diabetic participants was 0.717 for SBP, 0.494 for DBP, 0.712 for PP, 0.582 for MAP, and 0.721 for either SBP + DBP or PP + MAP. Equivalents in diabetes-free participants were 0.805, 0.763, 0.695, 0.801 and 0.813.<br />Conclusion: Office DBP was ineffective in discriminating optimal ambulatory BP control in diabetic patients, and did not improve predictions based on office SBP alone. Targeting ABPM to those T2DM patients who are already at optimal office-based SBP would likely be more cost effective in this setting.
- Subjects :
- Aged
Blood Pressure drug effects
Blood Pressure Monitoring, Ambulatory methods
Cameroon
Cross-Sectional Studies
Female
Humans
Hypertension drug therapy
Male
Middle Aged
Antihypertensive Agents therapeutic use
Blood Pressure Determination methods
Diabetes Mellitus, Type 2 physiopathology
Hypertension diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1937-8688
- Volume :
- 19
- Database :
- MEDLINE
- Journal :
- The Pan African medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 25838859
- Full Text :
- https://doi.org/10.11604/pamj.2014.19.231.2608