P1459PREVALENCE AND CONTROL OF HYPERTENSION AMONG PATIENTS ON HEMODIALYSIS USING PREDIALYSIS, POSTDIALYSIS AND HOME BP RECORDINGS

Abstract

Abstract Background and Aims Earlier studies provided considerably variable estimates on the prevalence and control rates of hypertension in hemodialysis because of their heterogeneity in definitions and blood pressure (BP) measurement techniques applied to detect hypertension. Method In the present study, 116 clinically stable hemodialysis patients from 3 dialysis centers of Northern Greece underwent home BP monitoring for 1 week with the validated automatic device HEM-705 (Omron, Healthcare). Routine BP recordings taken before and after dialysis over 6 consecutive sessions were also prospectively collected and averaged. Hypertension was defined as: (i) 1-week averaged home BP ≥135/85 mmHg; (ii) 2-week averaged predialysis BP ≥140/90 mmHg; (iii) 2-week averaged postdialysis BP ≥130/80 mmHg. Participants on treatment with ≥1 antihypertensives were also classified as hypertensives. Results The prevalence of hypertension was 88.8% by home, 86.2% by predialysis and 91.4% by postdialysis BP recordings. In all, 96 participants (82.7%) were being treated with an average of 1.7 antihypertensive medications. Among drug-treated participants, 32.6% were controlled by home, 50.5% by predialysis and 45.3% by postdialysis BP recordings. In multivariate logistic regression analysis, greater use of antihypertensive medications and postdialysis overhydration, assessed with bioimpendence spectroscopy, were both independently associated with higher odds of inadequate home BP control. Conclusion This study shows that epidemiology of hypertension in hemodialysis differs considerably between routine dialysis-unit and home BP recordings. Since greater antihypertensive drug use and postdialysis overhydration appeared to be the major determinants of inadequate home BP control, then management of hypertension should be initially relied on strategies targeting to control volume overload.