Hypertension is a leading risk factor for cardiovascular disease in South Asia. The authors aimed to assess the cross-country differences in 24-h ambulatory, daytime, and nighttime systolic blood pressure (SBP) among rural population with uncontrolled clinic hypertension in Bangladesh, Pakistan, and Sri Lanka. The authors studied patients with uncontrolled clinic hypertension (clinic BP ≥ 140/90 mmHg) who underwent ambulatory blood pressure monitoring (ABPM) during the baseline assessment as part of a community-based trial. The authors compared the distribution of ABPM profiles of patients across the three countries, specifically evaluating ambulatory SBP levels with multivariable models that adjusted for patient characteristics. Among the 382 patients (mean age, 58.3 years; 64.7% women), 56.5% exhibited ambulatory hypertension (24-h ambulatory BP ≥ 130/80 mmHg), with wide variation across countries: 72.6% (Bangladesh), 50.0% (Pakistan), and 51.0% (Sri Lanka; P < .05). Compared to Sri Lanka, adjusted mean 24-h ambulatory, daytime, and nighttime SBP were higher by 12.24 mmHg (95% CI 4.28–20.20), 11.96 mmHg (3.87–20.06), and 12.76 mmHg (4.51–21.01) in Bangladesh, separately. However, no significant differences were observed between Pakistan and Sri Lanka (P > .05). Additionally, clinic SBP was significantly associated with 24-h ambulatory (mean 0.38, 95% CI 0.28–0.47), daytime (0.37, 0.27–0.47), and nighttime SBP (0.40, 0.29–0.50) per 1 mmHg increase. The authors observed substantial cross-country differences in the distribution of ABPM profiles among patients with uncontrolled clinic hypertension in rural South Asia. The authors findings indicated the need to incorporate 24-h BP monitoring to mitigate cardiovascular risk, particularly in Bangladesh.

中文翻译：

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孟加拉国、巴基斯坦和斯里兰卡未受控制的临床高血压患者的动态血压水平

高血压是南亚心血管疾病的主要危险因素。作者旨在评估孟加拉国、巴基斯坦和斯里兰卡临床高血压未受控制的农村人口 24 小时动态血压、白天和夜间收缩压 (SBP) 的跨国差异。作者研究了未受控制的诊所高血压（诊所血压≥140/90 mmHg）患者，作为社区试验的一部分，他们在基线评估期间接受了动态血压监测（ABPM）。作者比较了三个国家患者的 ABPM 概况分布，特别是使用根据患者特征进行调整的多变量模型评估动态收缩压水平。在 382 名患者中（平均年龄 58.3 岁；64.7% 为女性），56.5% 患有动态高血压（24 小时动态血压 ≥ 130/80 mmHg），各国之间差异很大：72.6%（孟加拉国）、50.0%（巴基斯坦） ）和 51.0%（斯里兰卡；P  < .05）。与斯里兰卡相比，孟加拉国调整后的平均 24 小时动态、白天和夜间 SBP 分别高出 12.24 mmHg (95% CI 4.28–20.20)、11.96 mmHg (3.87–20.06) 和 12.76 mmHg (4.51–21.01)。分别地。然而，巴基斯坦和斯里兰卡之间没有观察到显着差异（P  > .05）。此外，每增加 1 mmHg，临床 SBP 与 24 小时动态血压（平均 0.38，95% CI 0.28-0.47）、白天（0.37，0.27-0.47）和夜间 SBP（0.40，0.29-0.50）显着相关。作者观察到，南亚农村地区未受控制的临床高血压患者的 ABPM 谱分布存在显着的跨国差异。作者的研究结果表明，需要纳入 24 小时血压监测来降低心血管风险，特别是在孟加拉国。