ASSOCIATION OF SHORT-TERM AND MID-TERM BLOOD PRESSURE VARIABILITY INDICES WITH LEFT VENTICULAR MASS INDEX IN CHRONIC KIDNEY DISEASE PATIENTS

Abstract

Objective: Several studies have demonstrated that increased blood pressure (BP) variability is associated with target-organ damage development in hypertensive patients. However, the impact of BP variability (BPV) indices on target-organ damage in chronic kidney disease patients (CKD) is unclear. Aim of the study was to evaluate the association between short-term and mid-term BPV indices with left ventricular mass index (LVMI) in chronic kidney disease patients. Design and method: A total of 131 CKD patients, referred for evaluation at the Hypertension Unit of our department, underwent 24-h ambulatory BP monitoring, home BP monitoring and echocardiographic measurements. Short-term BPV was expressed by standard deviation (SD), time rate (TR) of BP variation 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: All home BPV indices did not correlated significantly with LVMI. Regarding short-term BPV, only 24-h systolic TR (r = 0.320, p < 0.001) and daytime systolic TR of BP variation (r = 0.310, p < 0.001) significantly correlated with LVMI. The multivariate analysis revealed that 24-h systolic TR of BP variation was the only variable that was significantly and independently associated with LVMI (B = 12.016 95%CI 4.981–19.052, p < 0.001). The association remained significant after adjustment for baseline characteristics and risk factors. Conclusions: Short-term BPV indices such as 24-h and daytime systolic TR of BP variation were significantly associated with LVMI in CKD patients. In contrast, no significant association was observed between mid-term BPV indices and LVMI.