Ambulatory Blood Pressure Values Corresponding to the 2024 ESC Blood Pressure Categories in a Tunisian Population: A cross-sectional study

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Published Sep 13, 2026
https://doi.org/10.62438/tunismed.v104i08.6628
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Vol. 104 No. 08 (2026): Tunis Med Aug 2026

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Awatef Sassi
Laboratory of Cardiopulmonary System InteractionsLR14ES05, Sousse, Faculty of Medicine of Sousse, University of Sousse, 4000, Tunisia
Souhir Chelly
Department of Infection Prevention and Control, Laboratory of Cytogenetics, Molecular Genetics, and Human Reproductive Biology LR03SP02, Farhat Hached Hospital, Sousse, Faculty of Medicine of Sousse, 4000,University of Sousse, Tunisia
Imen Bouhlel
epartment of Cardiology, Laboratory of Cardiopulmonary System InteractionsLR14ES05, Sousse, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, 4000, Tunisia.
Mohamed Aymen Ben Abdessalem
Department of Cardiology, Laboratory of Cardiopulmonary System InteractionsLR14ES05, Sousse, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, 4000, Tunisia.
Aicha Laouani
Laboratory of Metabolic Biophysics and Applied Pharmacology, Sousse, USCR Analytical Platform UHPLC-MS & Research in Medicine and Biology, Sousse, Faculty of Medicine of Sousse, University of Sousse,4000, Tunisia
Maher Garbi
Department of Family Medicine, Sousse, Faculty of Medicine of Sousse, University of Sousse,Tunisia
Saad Saguem
Laboratory of Metabolic Biophysics and Applied Pharmacology, Sousse, USCR Analytical Platform UHPLC-MS & Research in Medicine and Biology, Sousse, Faculty of Medicine of Sousse, University of Sousse,4000, Tunisia
Abdallah Mahdhaoui
Department of Cardiology, Laboratory of Cardiopulmonary System InteractionsLR14ES05, Sousse, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, 4000, Tunisia.

Abstract

Background: Considerable progress has been made in defining thresholds for ambulatory blood pressure monitoring (ABPM) that are equivalent to office
blood pressure measurements (OBPM). However, standardized ABPM thresholds for different stages of hypertension are still lacking in specific populations,
including Tunisians. The aim was to determine ABPM values corresponding to the elevated blood pressure and hypertension categories of the 2024 ESC classification, and to provide local reference data for the Tunisian population.
Methods: It was a cross-sectional study involving Tunisian adults. Participants underwent blood pressure assessment using conventional oscillometer sphygmomanometer, followed by 24-hour ABPM. Office blood pressure was classified according to the 2024 ESC categories (non-elevated, elevated,hypertension). ABPM values corresponding to the elevated blood pressure and hypertension boundaries were identified using receiver operating characteristic (ROC) curve analysis to determine optimal cut-off values.
Results: A total of 403 were included, 274 men (68%) and 129 women (32%) with a mean age of 49.01 ± 12.44 years. Corresponding ABPM values for the elevated BP and hypertension boundaries, rounded to the nearest whole mmHg for clinical applicability, were, respectively: 121/67 mm Hg and 128/73 mm Hg for the 24-hour period; 125/71 mm Hg and 131/73 mm Hg for daytime; and 112/65 mm Hg and 112/66 mm Hg for nighttime.
Conclusion: To our knowledge, this is the first study conducted in Tunisia to determine ABPM values corresponding to the 2024 ESC blood pressure categories, based on real-world clinical data. The value identified ....(abstract truncated at 250 words).

Keywords:

Ambulatory Blood Pressure Monitoring, Reference Values, Diagnosis, Hypertension

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