THE EFFECTS OF FASTING ON BLOOD PRESSURE AND HYDRATATION STATUS IN HYPERTENSIVE PATIENTS DURING THE MONTH OF RAMADAN

Objective: Every year, millions of Muslims observe fasting during the month of Ramadan. During this holy month, eating habits, sleep, and activities are altered, which can affect blood pressure. The aim is to investigate the effects of fasting on blood pressure measurement and hydration status in hypertensive patients.Design and method: This is a prospective, analytical study including 35 hypertensive patients followed up in the cardiology department of Cheikh Khalifa Hospital in Casablanca between March and April 2024. Various blood pressure measurements, biological, and echocardiographic tests were conducted one week before Ramadan and during the last week of Ramadan. Results: The average age was 57 years with a sex ratio of 0.45. The average duration of hypertension was 3.9 years. 58.8% were on monotherapy, 38.2% on dual therapy, and 1 on triple therapy. Five patients had a history of chronic kidney disease and two of ischemic heart disease. The average systolic blood pressure before Ramadan was 134.7 ± 11.7 mmHg versus 131.7 ± 8.5 mmHg during Ramadan (p=0.03). The average diastolic blood pressure was 78.8 ± 8.5 mmHg before Ramadan versus 77 ± 6.5 mmHg during Ramadan (p=0.05). Regarding hydration status, we did not find a significant difference in renal function tests performed before Ramadan (average creatinine 8.4, eGFR 88 ml/min/m2) versus those during Ramadan (average creatinine 8.5, eGFR 89 ml/min/m2). However, among patients with chronic kidney disease, there was a significant worsening of renal function (p=0.03). Regarding echocardiographic data, grade I diastolic dysfunction was found in 51.4% of patients before and during Ramadan with a significant change in the diameter of the inferior vena cava from 12.6 to 7.6 mm. Conclusions: We can conclude that there was no significant increase in blood pressure during Ramadan and that patients with controlled hypertension can safely undertake fasting by adjusting the timing of medication intake. However, closer monitoring is needed for patients with a history of chronic kidney disease.