BACKGROUND: Hypertension is a leading cause of cardiovascular (CV) disease in the general population. Although hypertension is very common in maintenance hemodialysis (HD) patients, adequate blood pressure (BP) values and measurement timing have not been defined. METHODS: A total of 49 hypertensive HD patients were recruited. Average age was 63 ± 11 years, and duration of dialysis therapy was 6.2 ± 4.2 years. Dialysis unit BPs and various types of home BPs were separately measured, and which BPs were the most critical markers in evaluating the effect of hypertension on left ventricular hypertrophy and CV events was investigated. RESULTS: Predialysis systolic BPs were not correlated with any home BPs. Left ventricular mass index (LVMI) had a significant positive correlation with home BPs, especially morning systolic BPs on HD days (P < 0.01) and non-HD days (P < 0.05), on univariate and multivariate analysis. In contrast, predialysis BPs did not correlate with LVMI. During the follow-up period (47 ± 18 months), it was demonstrated that diabetes and home BPs, especially systolic BPs on the morning of HD days, were significant predictors of CV events on multivariate Cox regression analysis. A 10 mmHg increase in BP had a significantly elevated relative risk for CV events. CONCLUSIONS: Home BP, especially systolic BPs in the morning on HD days, can provide pivotal information for management of HD patients.
BACKGROUND:Hypertension is a leading cause of cardiovascular (CV) disease in the general population. Although hypertension is very common in maintenance hemodialysis (HD) patients, adequate blood pressure (BP) values and measurement timing have not been defined. METHODS: A total of 49 hypertensiveHDpatients were recruited. Average age was 63 ± 11 years, and duration of dialysis therapy was 6.2 ± 4.2 years. Dialysis unit BPs and various types of home BPs were separately measured, and which BPs were the most critical markers in evaluating the effect of hypertension on left ventricular hypertrophy and CV events was investigated. RESULTS: Predialysis systolic BPs were not correlated with any home BPs. Left ventricular mass index (LVMI) had a significant positive correlation with home BPs, especially morning systolic BPs on HD days (P < 0.01) and non-HD days (P < 0.05), on univariate and multivariate analysis. In contrast, predialysis BPs did not correlate with LVMI. During the follow-up period (47 ± 18 months), it was demonstrated that diabetes and home BPs, especially systolic BPs on the morning of HD days, were significant predictors of CV events on multivariate Cox regression analysis. A 10 mmHg increase in BP had a significantly elevated relative risk for CV events. CONCLUSIONS: Home BP, especially systolic BPs in the morning on HD days, can provide pivotal information for management of HDpatients.
Authors: K Iseki; F Miyasato; K Tokuyama; K Nishime; H Uehara; Y Shiohira; H Sunagawa; K Yoshihara; S Yoshi; S Toma; T Kowatari; T Wake; T Oura; K Fukiyama Journal: Kidney Int Date: 1997-04 Impact factor: 10.612
Authors: Antonio Alberto Lopes; Jennifer L Bragg-Gresham; Sylvia P B Ramirez; Vittorio E Andreucci; Takashi Akiba; Akira Saito; Stefan H Jacobson; Bruce M Robinson; Friedrich K Port; Nancy A Mason; Eric W Young Journal: Nephrol Dial Transplant Date: 2009-05-14 Impact factor: 5.992
Authors: Rajiv Agarwal; Allen R Nissenson; Daniel Batlle; Daniel W Coyne; J Richard Trout; David G Warnock Journal: Am J Med Date: 2003-09 Impact factor: 4.965
Authors: P G Zager; J Nikolic; R H Brown; M A Campbell; W C Hunt; D Peterson; J Van Stone; A Levey; K B Meyer; M J Klag; H K Johnson; E Clark; J H Sadler; P Teredesai Journal: Kidney Int Date: 1998-08 Impact factor: 10.612