Sistemik Lupus Eritematozus Hastalarında Hipertansiyon Sıklığı, Hipertansiyon Tanı ve Takibinde Ofis, Ev ve 24 Saatlik Ambulatuar Kan Basıncı Ölçümlerinin Karşılaştırılması

Abstract

Er E, The frequency of hypertension in systemic lupus erythematosus and the comparison of the office, home and 24-hour ambulatory blood pressure monitorizations for the diagnose and the management of hypertension in SLE. Hacettepe University Faculty of Medicine Department of Internal Medicine, Speciality Thesis, Ankara, 2013. Cardiovascular diseases are the important causes of morbidity and mortality in systemic lupus erythematosus (SLE). Hypertension (HT) is frequent in SLE. The aim of the study was to determine frequency of HT in SLE patients and to compare the value of office, home and 24-hour ambulatory blood pressure (BP) measurements for the diagnose and the management of HT in this patient group. The study was conducted with 90 SLE patients. All subjects had a complete medical history and physical examination. Office, home and 24-hour ambulatory BP measurements were performed in all patients. 50% of the SLE patients had HT. We observed that the concordance between the office, home and ambulatory BP measurements was low for determining patients with HT. The concordance between the office and ambulatory BP measurements was extremely low (Kappa: 0.21, p=0.044). The concordance between home and ambulatory BP measurements was moderate but less than ideally expected (Kappa: 0.51, p <0.001). Presence of higher number of cardiovascular risk factors was found to be a cause of discordance between home and ambulatory blood pressure measurements (OR 1.9 (CI 1.2-3.2); p=0.009). The concordance between home and ambulatory BP measurements were increasing by lower body mass index values (OR 0.76 (CI 0.61 - 0.95); p=0,017). In conclusion, the office BP measurements are insufficient for the evaluation of HT in SLE. Ambulatory BP measurements should be the preferred method for evaluation of HT in SLE. If ambulatory BP measurement is not available, home BP measurements can be used.