Characteristic of blood pressure profile in elderly hypertensive patients with chronic kidney disease: a tertiary hospital-based study

Abstract

To identify the characteristics of blood pressure (BP) in the elderly hypertensive patients with chronic kidney disease (CKD). We retrospectively recruited 337 CKD patients who had been admitted into our renal unit during January 2010 to December 2012 and undergone clinical blood pressure (CBP) and ambulatory blood pressure (ABP) measurement with detailed clinical data. Those with age ≥ 60 years old (n = 94) were designated as elderly patients and their BP data were compared with those of young- and middle-aged patients (< 60 years old, n = 243). Logistic regression was adopted to analyze the independent risk factor for white-coat hypertension and reverse-dipper rhythm. Compared to those < 60 y, the elder CKD patients had the following characteristics: (1) Higher prevalence of white-coat hypertension (24.5% vs 12.3%, P = 0.008). (2) Significantly lower diastolic blood pressure of average 24 h, daytime and nighttime by ambulatory monitoring of blood pressure (ABPM) (all P < 0.001). (3) Higher BP variability with significant difference (all P < 0.05) and more patients with morning surge (11.7% vs 3.7%, P = 0.009). (4) Higher prevalence of reverse-dipper circadian BP rhythm (41.5% vs 25.1%, P = 0.004). (5) Age was an independent predictor for white-coat hypertension (OR = 1.024, 95% CI: 1.004-1.044) and reverse-dipper circadian BP rhythm (OR = 1.016, 95% CI: 1.001-1.032). The BP profile of elderly hypertensive CKD patients is different from that of young- and middle-aged patients. ABPM should be more commonly performed to improve BP treatment of elderly CKD patients.