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Comparative Study
. 2024 Sep 4;24(1):472.
doi: 10.1186/s12872-024-04150-0.

Masked uncontrolled hypertension among elderly black sub-saharan africans compared to younger adults: a cross-sectional in-hospital study

Tresor Mvunzi Swambulu  1 , Yannick Samafundu Mundedi  1 , Yves Lubenga Nsimbi  1 , François Lepira Bompeka  2 , Aliocha Nkodila Natuhoyila  3 , Jean-Robert Makulo Risasi  2 , Cédric Ilunga  2 , Eleuthère Kintoki Vita  1 , Diane Kuntonda Kiese  1 , Noel Otshudi Onembo  1 , Roger Kongo Minga  4 , Olivier Tuyinama Madoda  5 , Jean-René M'buyamba-Kabangu  1 , Bernard Kianu Phanzu  6
Affiliations
Comparative Study

Masked uncontrolled hypertension among elderly black sub-saharan africans compared to younger adults: a cross-sectional in-hospital study

Tresor Mvunzi Swambulu et al. BMC Cardiovasc Disord. .

Abstract

Background: Although aging and being of African descent are well-known risk factors for masked uncontrolled hypertension (MUCH), data on MUCH among elderly black sub-Saharan Africans (BSSA) are limited. Furthermore, it is unclear whether the determinants of MUCH in younger individuals differ from those in the elderly.

Objective: This study aimed to determine the prevalence and risk factors associated with MUCH in both elderly and younger BSSA individuals.

Methods: In this study, 168 patients with treated hypertension were assessed for medical history, clinical examination, fundoscopy, echocardiography, and laboratory data. All patients underwent ambulatory blood pressure (BP) monitoring for 24 h. MUCH was diagnosed if the average 24-h mean BP ≥ 130/80 mmHg, the daytime mean BP ≥ 135/85 mmHg, and/or the nighttime mean BP ≥ 120/70 mmHg, despite controlled clinic BP (≤ 140/90 mmHg). Logistic regression analysis was performed to assess independent factors associated with MUCH, including elderly and younger adults separately. P-values < 0.05 were used to indicate statistical significance.

Results: Of the 168 patients aged 53.6 ± 11.6 years, 92 (54.8%) were men, with a sex ratio of 1.2, and, 66 (39%) were aged ≥ 60 years. The proportion of patients with MUCH (27.4% for all patients) was significantly higher (p = 0.002) among elderly patients than among younger patients (45.5% vs. 15.7%). Diabetes mellitus (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI], 1.27-4.46; p = 0.043), anemia (aOR, 3.18; 95% CI, 1.07-5.81; p = 0.043), hypertensive retinopathy (aOR, 4.50; 95% CI, 1.57-5.4; p = 0.043), and left ventricular hypertrophy (aOR, 4.48; 95% CI, 2.26-8.35; p = 0.043) were independently associated with MUCH in the elderly. In younger individuals, male gender (aOR, 2.16; 95% CI, (1.33-4.80); p = 0.029), obesity (aOR, 3.02; 95% CI, (1.26-5.32); p = 0.001), and left ventricular hypertrophy (LVH) (aOR, 3.08; 95% CI, (2.14-6.24); p = 0.019) were independently associated with MUCH were independently associated with MUCH.

Conclusion: MUCH is more prevalent among elderly than among younger BSSA individuals. Determinants of MUCH vary by age. MUCH prevention and management strategies should be age-specific.

Keywords: Elderly blacks; Masked uncontrolled hypertension; Prevalence; Risk factors; Sub-saharan africans.

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Conflict of interest statement

The authors declare no competing interests.

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