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. 2021;99(7):727-733.

Effects of Ramadan fasting on blood pressure in hypertensive patients

Ihsen Zairi, Mohamed Amine Bejar, Imtinen Ben Mrad, Khadija Mzoughi, Sondos Kraiem

Effects of Ramadan fasting on blood pressure in hypertensive patients

Ihsen Zairi et al. Tunis Med. 2021.

Abstract
in English, French

Introduction: During Ramadan, repeated cycles of fasting might contribute to changes in blood pressure among hypertensive patients. Studies on the effects of fasting on the blood pressure of hypertensive patients are scarce and have provided inconclusive results.

Aim: To examine the effect of fasting on ambulatory blood pressure and heart rate in treated hypertensive subjects.

Methods: The study prospectively recruited 60 hypertensive patients between April and June 2019, followed up at the cardiology department of Habib Thameur Hospital of Tunis. A 24-hour pressure monitoring was carried out during two periods: prior to Ramadan and during the last ten days of Ramadan. We compared the average values of 24 hour, awake and asleep systolic and diastolic blood pressure and 24 hour, awake and asleep heart rate.

Results: We studied 40 women and 20 men; mean age was 58.4 years. 33% of the patients were diabetics, 42% dyslipidemics, 15% had coronaropathy. 45% of the patients were on monotherapy, 37% on dual therapy and 18% on a triple antihypertensive therapy. During Ramadan, 74% of the patients were taking the treatment once daily, 3% twice daily, and 23% three times per day. Average 24hour ambulatory blood pressure in the whole group was 129±17/74±10 mmHg before Ramadan and 128±17/73±9 mmHg during Ramadan (p>0.05). Daytime and nighttime mean values of systolic and diastolic blood pressure as well as mean values of heart rate were not different between both periods regardless of age, gender, medical history and lifestyle.

Conclusions: In this study, there were no significant changes in systolic and diastolic blood pressures as well as heart rate during the 2 periods.

Introduction: Pendant Ramadan, le jeûne par intermittence ainsi que le changement d’horaire de prise des médicaments pourraient contribuer à modifier la pression artérielle et le rythme cardiaque des patients hypertendus.

Objectif : Examiner l'effet du jeûne sur la pression artérielle et la fréquence cardiaque chez des sujets hypertendus traités.

Méthodes: L'étude a recruté prospectivement 60 patients hypertendus, entre avril et juin 2019, et suivis au service de cardiologie de l'hôpital Habib Thameur de Tunis. Une mesure de la pression artérielle sur 24 heures a été effectuée pendant deux périodes: avant Ramadan et les dix derniers jours de Ramadan. La pression artérielle et la fréquence cardiaque sur vingt-quatre heures, en journée et au cours du sommeil ont été comparées.

Résultats : Nous avons étudié 40 femmes et 20 hommes, l'âge moyen était de 58,4 ans. 33,7% des patients étaient diabétiques, 41,7% dyslipidémiques, 15% coronariens. Les patients étaient sous monothérapie dans 45%, association dans 36,7% et sous triple thérapie dans 18,3% des cas. Durant Ramadan, les patients prenaient leurs médicaments une (73,4 %), deux (3,3 %) ou trois (23,3 %) fois par jour entre le coucher et le lever du soleil. La pression artérielle moyenne en ambulatoire sur 24 heures dans l'ensemble du groupe était de 129±17/74±10 mmHg avant Ramadan contre 128±17/73±9 mmHg pendant Ramadan (p>0.05). Nous n’avons pas trouvé de différence significative entre les PAS et PAD diurnes et nocturnes avant et pendant Ramadan, et ce y compris après ajustement sur l’âge, le sexe, les antécédents et le mode de vie.

Conclusion: Dans cette étude, il n'y a pas eu de changements significatifs des pressions artérielles systolique et diastolique et de la fréquence cardiaque entre les 2 périodes de surveillance.

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Figures

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Figure 1 :Antihypertensive drugs
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Figure 2 : 24-hour course of blood pressure values before Ramadan and during the last ten days of Ramadan
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