Relationship of ambulatory blood pressure monitoring data to echocardiographic findings in haemodialysis patients

Ertürk, Şehsuvar; Ertug, A. E.; Ateş, Kenan; Duman, Neval; Aslan, Serkan; Nergisoglu, G.; Diker, Erdem; Erol, Çetin; Karatan, Oktay; Erbay, Bülent

doi:10.1093/oxfordjournals.ndt.a027095

Cited by 59 publications

(45 citation statements)

References 20 publications

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“…Standardized techniques were used by several studies that were included in this review. Erturk et al (37) did not observe substantial differences in the recordings when using a standardized technique, but others (23,30,33,34,36,40) did. Studies that used the standardized measurements had as much variability in the difference between pre/postdialysis BP and ambulatory measurements as did nonstandardized studies.…”

Section: Discussionmentioning

confidence: 90%

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Pre- and Postdialysis Blood Pressures Are Imprecise Estimates of Interdialytic Ambulatory Blood Pressure

Agarwal

Peixoto

Santos

et al. 2006

Clinical Journal of the American Society of Nephrology

211

154

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H ypertension is perhaps one of the most pervasive problems of patients with ESRD. Although current guidelines that focus on cardiovascular disease in dialysis patients call for hypertension control as a top priority, the vast majority of patients who are on hemodialysis are hypertensive and control rates are poor (1). For practical reasons, BP assessment and antihypertensive treatment in patients with ESRD is performed on the basis of measurements that are made either immediately before or after dialysis. Such timehonored practice is widely accepted and formally recommended by clinical guidelines. The recent National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines suggest that predialysis and postdialysis BP should be Ͻ140/90 and Ͻ130/80 mmHg, respectively (2).Population-based studies, including the recent Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) (3) and Ohasama studies (4) and studies on patients who had hypertension and were referred to a specialist clinic in the Dublin Outcome Study (5), have demonstrated clearly that ambulatory BP monitoring (ABPM) provides more accurate prognostic information than office BP, an issue that seems to be of particular relevance in the elderly. In a recent analysis of the ABPM substudy of the Systolic Hypertension in Europe (Syst-Eur) trial (6), ABPM and clinic BP did not identify the same patients for antihypertensive treatment, and ABPM was a better predictor of cardiovascular outcomes than clinic BP. These considerations are of relevance to patients with ESRD because uremia is a strong catalyst of the aging process and because patients with ESRD are older, with an average age of 60 yr.Given that the population with ESRD is elderly and the relationship between ABPM and cardiovascular outcomes and total mortality has scarcely been studied, we examined the magnitude of the difference between ABPM and pre/postdialysis BP. We hypothesized that if there were substantial differences, especially when differences between the two methods of measurements were unpredictable, then the two methods of measurement may have differing prognostic significance. The primary objective of this systematic analysis was to determine the magnitude of the difference and the variability in the difference between BP that is recorded in the dialysis environment, before and after the dialysis procedure, and ABPM that is performed simultaneously in the hemodialysis population. Materials and MethodsPublished studies that had reported paired ABP and pre/postdialysis BP in patients who were undergoing conventional three times a Published online ahead of print. Publication date available at www.cjasn.org.

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Section: Discussionmentioning

confidence: 90%

“…The average ages reported varied from 31.6 to 61.2 yr. At least six studies excluded patients with diabetes (22,32,(35)(36)(37)(38). The average interdialytic weight gain ranged between 1.3 and 4.5 kg.…”

Section: Qualitative Analysismentioning

confidence: 99%

Pre- and Postdialysis Blood Pressures Are Imprecise Estimates of Interdialytic Ambulatory Blood Pressure

Agarwal

Peixoto

Santos

et al. 2006

Clinical Journal of the American Society of Nephrology

211

154

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“…It has been reported that ambulatory blood pressure monitoring (ABPM) data in dialysis patients are a better predictor for development of LVH and cardiovascular mortality than casual blood pressure (BP) measurements. 4,5 Casual BP measurements are far from being ideal to reflect BP levels precisely in dialysis patients and adjusting antihypertensive treatment according to casual BP measurements may cause an inadequate BP control. ABPM allows a better assessment in the course of BP levels during the day.…”

Section: Introductionmentioning

confidence: 99%

“…ABPM allows a better assessment in the course of BP levels during the day. 5,6 It was also reported that abnormal BP rhythm, which is common in patients with endstage renal failure, might be associated with target organ damage resulting from hypertension in women. 7 Numerous studies with 24-h ABPM have been reported in haemodialysis and CAPD patients.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients

et al. 2002

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The aim of this study was to compare the results of the 44-h ambulatory blood pressure monitoring (ABPM) data between haemodialysis (HDp) and CAPD patients and to investigate the relation of circadian rhythm in blood pressure (BP) with development of left ventricular hypertrophy. Twenty-two HDp (11 male, 11 female, mean age: 50 ± 17 years) and 24 CAPDp (11 male, 13 female, mean age: 47 ± 15 years) were included. Echocardiographic measurements and ABPM were performed in all study groups. ABPM of the first and second days were analysed separately and compared with CAPDp. Left ventricular hypertrophy was detected in 17 of the 22 HDp (77%) and 17 of the 24 CAPDp (71%). There was no significant differences between HD and CAPDp in respect to 44-h, daytime and night-time systolic and diastolic BP values. Although the course of BP in CAPDp was stable during the 44-h period, systolic and diastolic BP levels on the second day were significantly higher than those of on the first day in HDp (P Ͻ 0.001

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“…Therefore, it is hypothesized that these patients are exposed to higher blood pressures over 24 h and more frequent target organ damage. Related studies have revealed that nighttime blood pressure is associated with LVH [18][19][20][21] and is a predictor of negative cardiovascular outcomes in patients undergoing HD. 22,23 One study reported that cardiovascular survival was worse in patients with the ND blood pressure pattern compared to patients with the D blood pressure pattern, and it stated that an elevated 24 h pulse pressure and nighttime systolic blood pressure were associated with cardiovascular mortality.…”

Section: Discussionmentioning

confidence: 99%

Effects of nutritional parameters on nocturnal blood pressure in patients undergoing hemodialysis

et al. 2013

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Relationship of ambulatory blood pressure monitoring data to echocardiographic findings in haemodialysis patients

Abstract: ABPM is necessary to assess the adequacy of BP control, and is well correlated to end-organ damage of HT in HD patients.

Cited by 59 publications

References 20 publications

Pre- and Postdialysis Blood Pressures Are Imprecise Estimates of Interdialytic Ambulatory Blood Pressure

Pre- and Postdialysis Blood Pressures Are Imprecise Estimates of Interdialytic Ambulatory Blood Pressure

Ambulatory blood pressure monitoring in haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients

Effects of nutritional parameters on nocturnal blood pressure in patients undergoing hemodialysis

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