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Twenty-four hour ambulatory blood pressure reference values in Africans

Bawa-Allah, Abdulraheem B.; Mashao, Mercy M.; Nyundu, Thamsanqa F.; Phukubje, Edgar M.; Mlambo, Bongubuhle W.; Ngema, Mandisa V.; Nkosi, Brian G.; Maseko, Muzi J.

doi: 10.1097/MBP.0000000000000376
Clinical Studies

Objective We aimed to establish reference values for 24 h ambulatory blood pressure (ABP) monitoring in an African community.

Patients and methods We randomly recruited 1219 participants of African ancestry from Soweto, a township in Johannesburg. Twenty-four hour ABP was measured using ABP monitors (model 90207; Spacelab). Complete 24 h ABP measurements from 530 healthy participants with a mean age of 38 were used to determine thresholds.

Results Twenty-four hour, daytime and night-time systolic and diastolic BP increased significantly with age. The 95th prediction bands of this relation at age 38 years were ∼135/85 mmHg for 24 h, 140/90 mmHg for daytime and 130/80 mmHg for night-time ABP values, respectively. These thresholds and absolute ABP values are similar to those observed in individuals of other demographics. These thresholds increase with age by an average of 1.5 mmHg with each decade’s increase in age.

Conclusion Pending authentication in prospective outcome-based studies, these values might be considered preliminary thresholds to diagnose hypertension in individuals of African descent.

South African Hypertension and Diet Study, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Correspondence to Muzi J. Maseko, PhD, South African Hypertension and Diet Study, School of Physiology, University of the Witwatersrand Medical School, 7 York Road, Parktown, 2193 Johannesburg, South Africa Tel: +27 117 172 705/2363; e-mail:

Received June 13, 2018

Received in revised form February 22, 2019

Accepted March 15, 2019

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