DETERMINANTS OF SUBOPTIMAL BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS: 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING

Introduction: the study was conducted to define the determinants of suboptimal blood pressure (bp) control among hypertensive patients under treatment and explore a predictive model for detecting the patients at risk for increased bp.methods: we enrolled 97 patients (40 males, 57 females) under treatment for hypertension between june 2006 and may 2007 in shafa hospital, kerman, iran. bp was measured at clinic twice within 5-minute intervals. after setting up ambulatory blood pressure monitoring (abpm), bp was measured at 30-minute intervals during the day and 60-minute intervals during the night. the frequency of increased bp (more than 140/90 mmhg) was included in a regression model as dependent variable and all the others such as age, sex, body mass index (bmi), drugs and baseline clinical measurements as the predictors.results: increased bp was detected in 44% (95% ci: 38.79%-49.65%) of all measurements during 24-hour monitoring. the frequency of increased bp had a significant relationship with bmi (b=0.35, p=0.001). clinic's pulse pressure was a significant predicting factor for bp increase (p=0.02).conclusion: bmi and pulse pressure are the best predictors for being hypertensive during lifetime. ineffective treatment of hypertension is frequent among the hypertensive patients.