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An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes.
Pan Afr Med J 2014; 19:231PA

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).

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.

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.

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.

Authors+Show Affiliations

South African Medical Research Council & University of Cape Town, Cape Town, South Africa.Diabetes and Endocrine service, Yaounde Central Hospital, Yaounde, Cameroon.Service of Internal Medicine, General Hospital of Douala, Douala, & Buea faculty of Health Sciences, Buea, Cameroon.Service of Medicine A, General Hospital of Yaounde, Yaounde, Cameroon.Diabetes and Endocrine service, Yaounde Central Hospital, Yaounde, Cameroon.Service of Medicine A, General Hospital of Yaounde, Yaounde, Cameroon.Diabetes and Endocrine service, Yaounde Central Hospital, Yaounde, Cameroon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25838859

Citation

Kengne, Andre Pascal, et al. "An Assessment of Discriminatory Power of Office Blood Pressure Measurements in Predicting Optimal Ambulatory Blood Pressure Control in People With Type 2 Diabetes." The Pan African Medical Journal, vol. 19, 2014, p. 231.
Kengne AP, Libend CN, Dzudie A, et al. An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes. Pan Afr Med J. 2014;19:231.
Kengne, A. P., Libend, C. N., Dzudie, A., Menanga, A., Dehayem, M. Y., Kingue, S., & Sobngwi, E. (2014). An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes. The Pan African Medical Journal, 19, p. 231. doi:10.11604/pamj.2014.19.231.2608.
Kengne AP, et al. An Assessment of Discriminatory Power of Office Blood Pressure Measurements in Predicting Optimal Ambulatory Blood Pressure Control in People With Type 2 Diabetes. Pan Afr Med J. 2014;19:231. PubMed PMID: 25838859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An assessment of discriminatory power of office blood pressure measurements in predicting optimal ambulatory blood pressure control in people with type 2 diabetes. AU - Kengne,Andre Pascal, AU - Libend,Christelle Nong, AU - Dzudie,Anastase, AU - Menanga,Alain, AU - Dehayem,Mesmin Yefou, AU - Kingue,Samuel, AU - Sobngwi,Eugene, Y1 - 2014/10/31/ PY - 2013/03/17/received PY - 2014/02/04/accepted PY - 2015/4/4/entrez PY - 2014/1/1/pubmed PY - 2015/11/14/medline KW - Ambulatory blood pressure KW - Cameroon KW - diabetes mellitus KW - office blood pressure KW - prediction KW - sub-Saharan Africa SP - 231 EP - 231 JF - The Pan African medical journal JO - Pan Afr Med J VL - 19 N2 - 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). 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. 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. 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. SN - 1937-8688 UR - https://www.unboundmedicine.com/medline/citation/25838859/An_assessment_of_discriminatory_power_of_office_blood_pressure_measurements_in_predicting_optimal_ambulatory_blood_pressure_control_in_people_with_type_2_diabetes_ L2 - http://www.panafrican-med-journal.com/content/article/19/231/full/ DB - PRIME DP - Unbound Medicine ER -