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Comparative Study
. 2018 Jan 24:29:71.
doi: 10.11604/pamj.2018.29.71.12078. eCollection 2018.

Agreement between home and ambulatory blood pressure measurement in non-dialysed chronic kidney disease patients in Cameroon

Audrey Manto  1 , Anastase Dzudie  1   2   3 , Marie Patrice Halle  2   4 , Léopold Ndemnge Aminde  1   5 , Martin Hongieh Abanda  1 , Gloria Ashuntantang  6   7 , Kathleen Ngu Blackett  6   8
Affiliations
Comparative Study

Agreement between home and ambulatory blood pressure measurement in non-dialysed chronic kidney disease patients in Cameroon

Audrey Manto et al. Pan Afr Med J. .

Abstract

Introduction: home blood pressure measurement (HBPM) is not entirely capable of replacing ambulatory blood pressure (BP) measurement (ABPM), but is superior to office blood pressure measurement (OBPM). Although availability, cost, energy and lack of training are potential limitations for a wide use of HBPM in Sub-Saharan Africa (SSA), the method may add value for assessing efficacy and compliance in specific populations. We assessed the agreement between HBPM and ABPM in chronic kidney disease (CKD) patients in Douala, Cameroon.

Methods: from March to August 2014, we conducted a cross sectional study in non-dialyzed CKD patients with hypertension. Using the same devices and methods, the mean of nine office and eighteen home (during three consecutive days) blood pressure readings were recorded. Each patient similarly had a 24-hour ABPM. Kappa statistic was used to assess qualitative agreement between measurement techniques.

Results: forty-six patients (mean age: 56.2 ± 11.4 years, 28 men) were included. The prevalence of optimal blood pressure control was 26, 28 and 32% for OBPM, HBPM and ABPM respectively. Compared with ABPM, HBPM was more effective than OBPM, for the detection of non-optimal BP control (Kappa statistic: 0.49 (95% CI: 0.36 - 0.62) vs. 0.22 (95%CI: 0.21 - 0.35); sensitivity: 60 vs 40%; specificity: 87 vs. 81%).

Conclusion: HBPM potentially averts some proportion of BP misclassification in non-dialyzed hypertensive CKD patients in Cameroon.

Keywords: Chronic kidney disease; agreement; home (ambulatory) blood pressure monitoring.

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Figures

Figure 1
Figure 1
Bland-Altman plots showing agreement between OBPM and ABPM both systolic and diastolic
Figure 2
Figure 2
Bland-Altman plots showing agreement between HBPM and ABPM both systolic and diastolic
See this image and copyright information in PMC

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