Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

Abstract

Although both clinic blood pressure (BP) variability and home BP variability are associated with the risk of cardiovascular disease, the relationship between both BP variabilities remain unclear. We evaluated the association between visit-to-visit variability of clinic BP (VVV) and day-by-day home BP variability (HBPV) in patients with chronic kidney disease (CKD). We recruited 143 CKD patients in whom we performed HBP measurements every morning and evening over seven consecutive days. We obtained clinic BP data during 9.6 ± 1.0 consecutive visits within 24 months. The associations between the variables of VVV and HPBV were examined. In conclusion, VVV showed a weak but significant association with HBPV, especially the CV values of ESBP in CKD patients. Further studies are necessary to clarify whether these different BPV elements will be alternative marker of BPV.

High Systolic and Diastolic Blood Pressure Variability Is Correlated with the Occurrence of Peripheral Arterial Disease in the First Decade following a Diagnosis of Type 2 Diabetes Mellitus: A New Biomarker from Old Measurement

“…The other limitation of the present study is the absence of antihypertensive prescription fill data and information regarding patients' adherence to treatment regimens. However, low antihypertensive medication adherence explained only a small proportion of BP visit-to-visit variability [38], which implied that the absence of medication adherence data does not have a major impact on the results of the present study.…”

“…However, recent studies have shown that long-term visit-to-visit variability of BP may have greater prognostic value than mean BP or short-term variability [19, 37, 38]. These studies recommended that optimal antihypertension treatment included avoidance of inconsistent BP control and large BP visit-to-visit variability [36].…”

The risk of visit-to-visit blood pressure variability in chronic kidney disease

“…Furthermore, in diabetic patients, both mortality [12,13] and cardiovascular diseases [12][13][14][15] have been associated with VVV also. Similarly, in patients after a first event of coronary heart disease [16,17], stroke [18,19], or acute heart failure [20], the higher the VVV the higher is the risk for a second event or hospitalization. Similarly, high VVV of BP was associated with endothelial damage [21], increased arterial stiffness [22], progression of coronary artery calcification [23], and left ventricular diastolic dysfunction [24], all of which may contribute to risk of death and cardiovascular outcomes.…”

24ωρη Καταγραφή Της Αρτηριακής Πίεσης Και Καταγραφή Της Αρτηριακής Πίεσης Στο Σπίτι Βάση Πρωτοκόλλου Σε Ασθενείς Με Χρόνια Νεφρική Νόσο

“…Αποτελέσματα συσχέτισης της VVV με την θνητότητα 268,269 και τα καρδιαγγειακά συμβάματα [268][269][270][271] είχαμε και από μελέτες σε διαβητικούς ασθενείς. Σε ασθενείς μετά από ένα συμβάν οξέος στεφανιαίου συνδρόμου 272,273 , αγγειακού εγκεφαλικού επεισοδίου 274,275 , ή οξείας καρδιακής ανεπάρκειας 276…”