Blood Pressure Variability, Cardiovascular Diseases, Hypertension
Conditions
Keywords
blood pressure variability, Hypertension, cardiovascular diseases
Brief summary
Cardiovascular Disease (CV) including stroke is the leading cause of death in Malaysia Hypertension is a major contributor to this. Prevalence of hypertension in Malaysia is high (42%) in adults age 30 years or older. Besides the actual blood pressure (BP) level recently, blood pressure variability (BPV) has been recognized as an independent and strong predictor of CV events especially strokes. However, data on the BP variability and its relationship to CV events is very limited in Asia, particularly in Malaysia. Hence the investigators aim to study BPV and its relationship to CV events in treated hypertensive patients
Detailed description
This will be a cross-sectional study on patients with hypertension. The 10-year retrospective data on BP, treatment, biochemical changes, kidney function and CV events will be extracted from patient records. Eligible patients who have given written informed consent will be given a questionnaire capturing data of their socio-demographic status, weight, height and BP measured. Those agreeable to measure their own BP at home 3 times a day for a week will be loaned a BP device to measure their own BP at home. The home BP readings will be recorded onto a provided form and returned to the investigators. Data will be analysed to 1. determine BPV of the clinic visit-to-visit BPV (long tem BPV) 2. determine the day to day BPV (short term BPV) 3. examine the BPV to CV events, kidney function, cognition 4. determine the prevalence of white coat and masked hypertension 5. determine the level of control of BP 6. examine the relationship of ownership of home BP devices to control and satisfaction of treatment
Interventions
OTHERnon-interventional
No intervention
Sponsors
University of Malaya
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients on treatment for hypertension of at least 3 years * Patients who consent to the study
Exclusion criteria
* those unable to give consent * recent (less than 6 months) of cardiovascular events (stroke, heart attack, heart failure) * patients on dialysis * patients with end stage kidney failure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The standard deviation value of blood pressure variability in treated hypertensive patients | 31 Dec 2020 | The various indices of day-to-day and long term Blood pressure variability will be calculated giving the actual BPV (in absolute number ) in these patients |
| Percentage of cardiovascular events in those with higher BPV compared to those with lower BPV | 31 Dec 2020 | BPV will be categorized as above or below the mean BPV of the entire group. The number of CV events in percentage in each group will be compared It is expected that those with higher BPV will have more CV events |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Treated hypertensives with White Coat or Masked hypertension | 31 Dec 2020 | The Home and Clinic BP measurements will be used to determine the percentage of Masked and White Coat Hypertension. These two conditions are expected to be associated with more CV events than those with control of both clinic and home BP. |
| Difference in cognition in those with higher BP variability compared to those with lower BPV | 31 Dec 2020 | The Montreal Cognitive Assessment (MoCA) score will be compared between those with higher with those with lower BPV. The minimum MoCA score is 0 and the maximum is 30. A higher MoCA score indicates better cognition. A MoCA score of 26 is considered as normal. The MoCA score is expected to be lower in those with higher BPV. |
Countries
Malaysia
Outcome results
None listed