24‐Hour Ambulatory Blood Pressure Monitoring during Ramadan Fasting: A Three‐Year Cross‐Sectional Study From a Tertiary Medical Center in Turkey

Ramadan fasting involves prolonged daily abstinence from food and water and may affect blood pressure (BP) regulation, particularly in individuals with chronic conditions. Evidence focusing specifically on ambulatory BP characteristics during Ramadan remains limited. This study evaluated 24-hour ambulatory BP monitoring (ABPM) parameters obtained during Ramadan in fasting and non-fasting individuals. In this prospective cross-sectional study, 231 adults underwent 24-hour ABPM during Ramadan between 2021 and 2023. Participants were classified as fasting or non-fasting and as hypertensive or non-hypertensive. Demographic characteristics, comorbidities, laboratory findings, and echocardiographic parameters were recorded. Ambulatory BP values were analyzed for 24-hour, daytime, and nighttime periods. Of the participants, 117 were fasting and 114 were non-fasting. Baseline demographic characteristics and cardiovascular comorbidities were similar between groups, although diabetes mellitus (DM) and chronic kidney disease (CKD) were more frequent in non-fasting individuals. No significant differences were observed in 24-hour or daytime systolic and diastolic BP values. Mean nighttime BP was lower in fasting participants (p = 0.032). Echocardiographic parameters were comparable. Fasting individuals had higher serum albumin levels (p = 0.027) and lower neutrophil counts (p = 0.030), while other biochemical markers did not differ significantly. Ramadan fasting was not associated with adverse ambulatory BP changes in hypertensive or normotensive individuals and may be considered safe in appropriately selected patients with well-controlled hypertension (HT).