Biochemical and Chemical Lipid Profile and Blood Pressure Assessment in Arterial Hypertension with Chronic Kidney Disease

Teim Baaj,Silviu Latcu,Adina Elena Protesi,Mircea Botoca,Alin Cumpanas,Sebastian Plesa,Octavian Marius Cretu,Shamsa Baaj,Andrei Paunescu,Ioan Musta,Elena Ardeleanu,Ioan Tilea,Laurentiu Sima,Andrei Rusmir,Ahmed Abu-Awwad

doi:10.37358/rc.20.7.8260

Abstract

Accelerated atherosclerosis and cardiovascular diseases are frequent complications in hypertensive patients with chronic kidney disease (CKD), being mainly driven by cardiovascular risk factors as lipid disorders and an unfavorable blood pressure profile. The objectives of the study were to evaluate the lipid profile and to assess the characteristics of blood pressure (BP) in patients with primary arterial hypertension associating chronic kidney disease (CKD) in a primary care population in Timis County, Romania. Lipid disorders were highly prevalent in hypertensive patients with CKD, consisting in hyper LDL-cholesterolemia in 50.3%, hypertriglyceridemia in 52%, low HDL-cholesterol levels in 35.8%. More than 2 lipid abnormalities were present in 68.8% of CKD hypertensive. CKD hypertensive patients, compared with those without CKD, presented a BP profile with higher systolic and diastolic office BP. On ambulatory blood pressure monitoring they also registred higher systolic and diastolic BP, the systolic BP (SBP), both for 24 h SBP, day-time and night-time SBP being statistically significant higher than in hypertensive patients without CKD. The circadian 24 h BP profile demonstrated in the CKD hypertensive population an unfavourable nocturnal profile in 67%, consisting of a high prevalence of the non-dipping profile and of nocturnal riser pattern.

Highlights

The prevalence of chronic kidney disease (CKD) (Chronic Kidney Disease) mediated by hypertension demonstrates a rising tendency worldwide and in Romania
The mean age of the hypertensive population with CKD was 62.1±12.5 years, being higher than of the total hypertensive population (49.45 ± 18.28 years), OR = 1.151, 95% confidence interval (CI) = 1.112–1.194, p
The mean duration of hypertension with CKD was 6.45 ± 3.47 years, compared with a shorter mean HT duration in hypertension without CKD of 6.14 ± 3.51 years

Summary

Introduction

The prevalence of CKD (Chronic Kidney Disease) mediated by hypertension demonstrates a rising tendency worldwide and in Romania. Studies have demonstrated that high levels of blood pressure (BP) are positively and significantly related to the decline of the kidney function among the hypertensive population. In the absence of complete and careful assessment of the entire 24 h, daytime and night-time BP pattern with ambulatory blood pressure monitoring (ABPM), the diagnosis of hypertension in CKD patients can be inaccurate and sometime missed. In Romanian primary care units, the diagnosis of hypertension is mainly based on office BP measurements, completed by home blood pressure monitoring and only rarely evaluated with ABPM. ABPM has become increasingly more used in primary care units in Timis County, as studies have demonstrated that it provides more reliable and reproducible information about BP, being more closely related to target organ damage, cardiovascular (CV) events and prognosis

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