A Study of Ambulatory Blood Pressure Monitoring in Undergraduate Medical Students in a Tertiary Care Hospital in North India.

BACKGROUND

Hypertension, a prevalent health issue worldwide, is a leading risk factor for cardiovascular disease and often coexists with other metabolic conditions. Despite its treatability, the specific mechanisms leading to organ damage from hypertension are not fully understood. This study aimed to evaluate blood pressure (BP) patterns among medical students using 24-hour ambulatory blood pressure monitoring (ABPM) and examine the relationship between these patterns and various associated factors.

METHODOLOGY: This study was conducted at a tertiary care center in North India and involved 75 undergraduate medical students. Data collected included demographic details, height, weight, body mass index (BMI), smoking history, alcohol intake, physical activity, and family history of hypertension. A structured questionnaire was used to gather information, and BMI was calculated for each participant. Office BP measurements were taken, followed by ABPM the next day.

RESULTS

The results revealed that 41 (54.6%) of the participants were male and 34 (45.3%) were female, with most students aged 20-22 years. BMI distribution showed 30.67% had normal BMI, 30.67% were overweight, and 38.6% were obese. Office BP measurements identified only 13.3% as hypertensive. ABPM identified 38.6% of participants as hypertensive by at least one criterion (24-hour mean BP, daytime mean BP, or nighttime mean BP). White coat hypertension was present in 6 (8.5%) participants, and 25 (33.3%) participants had masked hypertension. There was no significant correlation of hypertension with gender, BMI, exercise, or family history of hypertension. Normal dipping was seen in 23 (30.67%) participants, 46 (61.3%) were nondippers, and 3 (4%) each were reverse and extreme dippers. There was no significant correlation of dipping patterns with gender, BMI, exercise, or family history of hypertension. Hypertensive individuals, along with nondippers and reverse dippers, were referred for further evaluation.

CONCLUSION

In our study, 29 participants were found to be hypertensive on ABPM, and 49 participants had abnormal dipping patterns. This increase in BP or abnormal dipping observed at such a young age is alarming. This was a single-center study with a small sample size, and therefore the results cannot be generalized to larger population sizes. Further multicenter studies in young patients with a larger sample size are required.