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Home systolic blood pressure on the morning of dialysis days has prognostic impact for hypertensive hemodialysis patients.

Ogura M, Yamada Y, Terawaki H, Hamaguchi A, Kimura Y, Hosoya T - Clin. Exp. Nephrol. (2011)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. mogura@jikei.ac.jp

ABSTRACT

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.

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Correlation with left ventricular mass index (LVMI) and various types of blood pressures (BPs). LVMI demonstrated significant correlation with morning BPs on hemodialysis (HD) (R = 0.50, P < 0.01) and non-HD (R = 0.41, P < 0.01) days. In contrast, LVMI did not have a correlation with predialysis BPs (R = 0.27, NS)
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Fig1: Correlation with left ventricular mass index (LVMI) and various types of blood pressures (BPs). LVMI demonstrated significant correlation with morning BPs on hemodialysis (HD) (R = 0.50, P < 0.01) and non-HD (R = 0.41, P < 0.01) days. In contrast, LVMI did not have a correlation with predialysis BPs (R = 0.27, NS)

Mentions: As shown in Fig. 1, home BPs, especially morning systolic BPs on HD and non-HD days, had a significant positive correlation with LVMI (r = 0.50, P < 0.01 and r = 0.41, P < 0.01, respectively). On the other hand, predialysis BP did not correlate with LVMI (r = 0.27, NS). Multivariate analysis including various factors (HD vintage, age, gender, diabetes, ARB, and BPs) demonstrated that only morning systolic BPs on HD and non-HD days had significant correlation with LVMI (Table 3).Fig. 1


Home systolic blood pressure on the morning of dialysis days has prognostic impact for hypertensive hemodialysis patients.

Ogura M, Yamada Y, Terawaki H, Hamaguchi A, Kimura Y, Hosoya T - Clin. Exp. Nephrol. (2011)

Correlation with left ventricular mass index (LVMI) and various types of blood pressures (BPs). LVMI demonstrated significant correlation with morning BPs on hemodialysis (HD) (R = 0.50, P < 0.01) and non-HD (R = 0.41, P < 0.01) days. In contrast, LVMI did not have a correlation with predialysis BPs (R = 0.27, NS)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3376255&req=5

Fig1: Correlation with left ventricular mass index (LVMI) and various types of blood pressures (BPs). LVMI demonstrated significant correlation with morning BPs on hemodialysis (HD) (R = 0.50, P < 0.01) and non-HD (R = 0.41, P < 0.01) days. In contrast, LVMI did not have a correlation with predialysis BPs (R = 0.27, NS)
Mentions: As shown in Fig. 1, home BPs, especially morning systolic BPs on HD and non-HD days, had a significant positive correlation with LVMI (r = 0.50, P < 0.01 and r = 0.41, P < 0.01, respectively). On the other hand, predialysis BP did not correlate with LVMI (r = 0.27, NS). Multivariate analysis including various factors (HD vintage, age, gender, diabetes, ARB, and BPs) demonstrated that only morning systolic BPs on HD and non-HD days had significant correlation with LVMI (Table 3).Fig. 1

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. mogura@jikei.ac.jp

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus