Effect of vitamin D on the variability of blood pressure in premenopausal and menopausal hypertensive women in the area of Blida (Algeria).

OBJECTIVE: To evaluate the effect of 25 (OH) vitamin D supplementation on blood pressure (BP) variability in hypertensive women in the pre-menopausal and post-menopausal periods. MATERIALS AND METHODS: 881 hypertensive women prospectively followed for an interventional study between January 2016 and September 2017, in specialized consultation at the department of internal medicine at the Blida University Hospital (Algeria). Four hundred and thiry nine premenopausal women (group I) and 442 menopausal women (group II). The initial serum 25 (OH) D level for each group was determined by the enzyme immunoassay. In groups I and II, we identified 2 subgroups, A: insufficiency (vit D between 29 and 20ng/ml) and B: deficiency (vit D less than 20ng/L). Antihypertensive therapy was supplemented with an additional 200000IU/month cholecalciferol for the two B subgroups. The variability in BP was calculated as the ratio of mean systolic and diastolic BP during daytime and nighttime, with performing ambulatory BP measurement at baseline, 3, 6, and 12 months of follow-up. RESULTS: At inclusion, the level of 25 (OH) D was lower (P<0.05) in subgroups IB (19.3±8.5ng/ml) and IIB (18.2±9, 5ng/ml) compared to subgroups IA (28.1±10.7ng/ml) and IIA (25.2±10.1ng/ml). After supplementation, the level of 25 (OH) D increased in subgroup IB (38.3±11.9ng/ml) and in subgroup IIB (37.3±10, 5ng/ml) and became higher (P<0.001) than in subgroups IA and IIA. Between subgroups IA and IB, at inclusion, there is no difference (P>0.05) in the SBP and DBP variability during the day and at night. After treatment, the variability of the SBP at night became lower (P<0.02) in group IB compared to group IA. In subgroup IIB, daytime variability indices were higher (P=0.04) at inclusion than in group IIA. After treatment, the variability of SBP during the day decreased but remained the highest (P<0.05) in subgroup IIB (14.8±10.8mmHg) compared to subgroup IB (12.0±8.1mmHg), as well as to subgroups IIA (10.9±9.8mmHg) and IA (10±8.1mmHg). We found a significant correlation of cholecalciferol with the variability of SBP during the day. CONCLUSIONS: Vitamin D deficiency appears to be a factor of BP variability. Although the variability of the postmenopausal group remains higher than that of the other groups, the correction of the level of 25 (OH) D by the supply of cholecalciferol 200000 IU per month leads to a reduction in the variability of BP in the studied hypertensive women could help to prevent morbimortal complications.

Differences in prevalence, treatment and control rates of hypertension between male and female in the area of Blida (Algeria).

PURPOSE: To compare differences in prevalence rates, treatment and control of hypertension (AHT) between males and females in general medicine consultation in the area of Blida (Algeria). METHODS: We included 3622 patients in the study (42% males and 58% females), with a mean age of 48.14±10.11 years, examined between January 2014 and June 2016 in general medicine consultation in the area of Blida (Algeria). Data was collected with individual questionnaires. Measurement of blood pressure was made using validated semi-automatic devices (OMRON HEM model 705CP). Individuals using antihypertensive drugs and/or blood pressure (BP) greater than or equal to 140/90mmHg were considered as hypertensives. The knowledge about the disease was identified among those who claimed to be aware of the diagnosis before the measurements. The treatment rate was calculated with those who reported using antihypertensive drugs. Controlled blood pressure was considered in individuals with values lower than 140/90mmHg. Lipid profile (total cholesterol, triglycerides, HDL and LDL cholesterol), and fasting blood sugar were measured. All calculations and statistical analyses are processed by the SPSS 20.0. RESULTS: The prevalence of hypertension was higher among men (46.2%) than women (31.6%) (P<0.001), and among aged over 55 years (P< 0.05) and those that have referred hypertensive parents (P<0.05). Among hypertensive men, 55.7% knew the diagnosis, 63.6% of them were under treatment, and 22% had controlled BP. Among the hypertensive women 69.8% knew the diagnosis, 85.1% were under treatment and 35.6% were with controlled BP (P<0.001 for the three variables). The most frequent associated risk factors were diabetes mellitus in 36.8% of the patients, obesity in 35.7% of the patients, microalbuminuria in 23.6% of the patients, hypercholesterolemia>2g/L in 11.6% of the patients, smoking in 7.7% of them. Presence of controlled AHT was not found to be associated with presence of other risk factors. The likelihood of having AHT was higher among men, diabetics, older subjects and higher BMI. CONCLUSION: Our study confirmed the high prevalence of AHT in general medicine consultation in Blida, which is a representative city in the north of Algeria. Although women are better treated, much remains to be done to reach BP goal, much in our countries which have the least financial resources to combat cardiovascular disabilities.

[The characteristics of arterial hypertension in postmenopausal women in the area of Blida (Algeria)]. / Les caractéristiques de l'hypertension artérielle chez la femme ménopausée dans la région de Blida (Algérie).

OBJECTIVE: Assess the prevalence, the degree of control, and the comorbidities of hypertension in postmenopausal women. DESIGNS AND METHODS: This is a cohort descriptive and prospective study conducted in 2years in a population with hypertension treated for arterial hypertension in specialized university hospital in Blida, which included one thousand seven hundred and twenty-one postmenopausal women with amenorrhea fore more than 12 consecutive months. All anthropometric data were recorded. All cardiovascular complications were sought. All calculations and statistical analysis are processed by the SPSS 20.0. RESULTS: The mean age of onset menopause is 50.7±6.2yearsold. The prevalence of hypertension is 71%, significantly higher in postmenopausal women aged 65 and over. Among women, 82.3% had a systolic arterial pressure>150mmHg and 42.2% had a diastolic arterial pressure>90mmHg. The prevalence of diabetes was 34.8%, and 88.4% presented type 2 diabetes. Tobacco in 1.3%, hypoHDLmia in 52%, the hypertriglyceridemia in 43.5%, obesity in 31.7%. The metabolic syndrome in 57.8%. The major cardiovascular complications observed are: stroke in 26.4%, heart failure in 14.8%, myocardial infarction in 13.2%, renal failure in 10.1%. The control of high blood pressure is achieved only in 31.7%. CONCLUSIONS: The systolic blood pressure is more important than the diastolic blood pressure in postmenopausal women. The cerebral vascular accident remains the most feared complication. The control of hypertension remains not enough and the balance of arterial pressure figures is highly recommended to avoid morbidity and fatal complications.