Abstract

BackgroundBlood pressure is an important and modifiable cardiovascular risk factor. Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. The goal of this study was to investigate whether ambulatory blood pressure is better associated with TOD than clinic blood pressure in patients with primary glomerular disease.Methods1178 patients with primary glomerular disease were recruited in this cross-sectional study. TOD were assessed by the following 4 parameters: left ventricular mass index (LVMI or LVH, left ventricular hypertrophy), estimated glomerular filtration rate (eGFR< 60 ml/min/1.73m2), albumin-to-creatinine ratio (ACR ≥ 30 mg/g) and carotid intima-media thickness (cIMT) or plaque. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were used to evaluate the relationship between ambulatory or clinic systolic blood pressure (SBP) indexes and TOD.ResultsAmong 1178 patients (mean age, 39 years,54% men), 116, 458, 1031 and 251 patients had LVH, eGFR < 60 ml/min/1.73m2, ACR ≥ 30 mg/g and cIMT≥0.9 mm or plaque respectively. Area under ROC curves for TOD in ambulatory SBP, especially nighttime SBP, was greater than that in clinic SBP (P < 0.05). Multivariate logistic regression analyses showed that 24 h SBP, daytime SBP and nighttime SBP were significantly associated with LVH, eGFR< 60 ml/min/1.73m2 and ACR ≥ 30 mg/g after adjustment for clinic SBP, while the association of clinic SBP was attenuated after further adjustment for nighttime SBP.ConclusionsAmbulatory blood pressure, especially nighttime blood pressure, is probably superior to clinic blood pressure and has a significant association with TOD in primary glomerular disease patients.

Highlights

  • Blood pressure is an important and modifiable cardiovascular risk factor

  • All these data suggested Ambulatory blood pressure monitoring (ABPM) was better than clinic blood pressure when assessing target organ damage (TOD) and prognosis in chronic kidney disease (CKD) patients

  • Patients were excluded from the study in case of: 1) diabetes mellitus; 2) acute changes in the estimated Glomerular Filtration Rate (eGFR) > 30% in the previous 3 months; 3) maintenance dialysis or history of kidney transplantation; 4) cardiovascular disorders; 5) pregnancy; 6) night work or shift-work employment; 6) intolerance to ABPM or invalid ABPM data; 7) inability to communicate and comply with all of the study requirements; a total of 1178 patients from our hospitals were enrolled in this study (Fig. 1)

Read more

Summary

Introduction

Ambulatory blood pressure monitoring (ABPM) provides valuable prognostic information in patients with chronic kidney disease (CKD), yet little is known about the association of various types of BP measurements with target organ damage (TOD) in patients with primary glomerular disease. Recent evidence from large-scale cohort study suggests that higher 24-h and nighttime blood pressure measurements were significantly associated with greater risks of death and cardiovascular disease, even after adjusting for other office-based or ambulatory blood pressure measurements [11]. All these data suggested ABPM was better than clinic blood pressure when assessing target organ damage (TOD) and prognosis in CKD patients

Objectives
Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call