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Prospective blood pressure measurement in renal transplant recipients.

David VG, Yadav B, Jeyaseelan L, Deborah MN, Jacob S, Alexander S, Varughese S, John GT - Indian J Nephrol (2014)

Bottom Line: Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM.When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively.HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54).

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Christian Medical College/Hospital, Vellore, Tamil Nadu, India.

ABSTRACT
Blood pressure (BP) control at home is difficult when managed only with office blood pressure monitoring (OBPM). In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM) was compared with ambulatory blood pressure monitoring (ABPM) as the gold standard. Adult patients who had living-related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2(nd), 4(th), 6(th), and 9(th) months and all the three methods: OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%). Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6-8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa: 0.88 vs. 89% specificity, Kappa: 0.71). HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54). In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control.

No MeSH data available.


Related in: MedlinePlus

Awake systolic blood pressure in ambulatory blood pressure monitoring and office systolic blood pressure
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Figure 1: Awake systolic blood pressure in ambulatory blood pressure monitoring and office systolic blood pressure

Mentions: The mean difference plot of SBP for different time points is shown in Figure 1. At the pretransplant phase, the scatter was evenly distributed over the range of SBP suggesting that there is an even estimation of SBP for the particular range of SBP. However, during the post transplant phase there was a systematic over estimation of SBP by OBPM at all points, with a good agreement.


Prospective blood pressure measurement in renal transplant recipients.

David VG, Yadav B, Jeyaseelan L, Deborah MN, Jacob S, Alexander S, Varughese S, John GT - Indian J Nephrol (2014)

Awake systolic blood pressure in ambulatory blood pressure monitoring and office systolic blood pressure
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127834&req=5

Figure 1: Awake systolic blood pressure in ambulatory blood pressure monitoring and office systolic blood pressure
Mentions: The mean difference plot of SBP for different time points is shown in Figure 1. At the pretransplant phase, the scatter was evenly distributed over the range of SBP suggesting that there is an even estimation of SBP for the particular range of SBP. However, during the post transplant phase there was a systematic over estimation of SBP by OBPM at all points, with a good agreement.

Bottom Line: Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM.When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively.HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54).

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Christian Medical College/Hospital, Vellore, Tamil Nadu, India.

ABSTRACT
Blood pressure (BP) control at home is difficult when managed only with office blood pressure monitoring (OBPM). In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM) was compared with ambulatory blood pressure monitoring (ABPM) as the gold standard. Adult patients who had living-related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2(nd), 4(th), 6(th), and 9(th) months and all the three methods: OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%). Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6-8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa: 0.88 vs. 89% specificity, Kappa: 0.71). HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54). In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control.

No MeSH data available.


Related in: MedlinePlus