ASSOCIATION OF DIFFERENT TYPES OF BLOOD PRESSURE VARIABILITY WITH ARTERIAL STIFFNESS MARKERS IN CHRONIC KIDNEY DISEASE PATIENTS

Abstract

Objective: It is well known that blood pressure (BP) variability is associated with development of target-organ damage in hypertensive patients. However, the significance of this association in chronic kidney disease patients (CKD) remains unclear. Aim of the study was to examine the association between BPV indices derived from ambulatory and home BP monitoring and arterial stiffness markers such as pulse wave velocity (PWV) and augmentation index (AI) in CKD patients. Design and method: A total of 105 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent 24-h ambulatory BP monitoring, home BP monitoring and measurements of PWV and AI. Short-term BPV was expressed by standard deviation (SD), time rate (TR) of BP variation, average real variability (ARV) and coefficient of variation (CV) of systolic and diastolic BP for both 24-h, daytime and nighttime intervals. Mid-term BPV was expressed by SD and CV of systolic and diastolic BP for morning and evening BP measurements. Statistical analysis was performed by means of bivariate correlations, simple and multiple linear regression analysis. Results: The mid-term BPV indices of systolic home SD (r = 0.286, p = 0.003) and CV (r = 0.216, p = 0.027) were significantly correlated with AI. Regarding short-term BPV, nighttime systolic SD (r = 0.238, p = 0.016), nighttime systolic TR of BP variation (r = 0.194, p = 0.050) and nighttime systolic ARV (r = 0.264, p = 0.007) were significantly correlated with PWV. Conclusions: Short-term nighttime systolic BPV indices such as SD, TR of BP variation and ARV were significantly associated with PWV in CKD patients. The mid-term BPV indices of systolic SD and CV were significantly associated with AI.