SEX DIFFERENCES IN SHORT-TERM BP VARIABILITY AMONG PATIENTS UNDERGOING PERITONEAL DIALYSIS

Abstract

Objective: The present study aimed to explore potential differences in short-term blood pressure (BP) variability between men and women with end-stage kidney disease undergoing peritoneal dialysis (PD). Design and method: In this comparative study, 48 male PD patients from Northern Greece were matched for age and history of heart failure with 48 female patients in a 1:1 ratio. All patients underwent 24-hour ambulatory BP monitoring with the oscillometric device Mobil-O-Graph (IEM, Stolberg, Germany). Short-term BP variability was assessed with the calculation of standard deviation (SD), coefficient of variation (CV) and average real variability (ARV) of systolic and diastolic BP during the 24-hour, daytime and nighttime periods. Results: Age, the duration of PD therapy and the prevalence of cardiovascular comorbidities were similar in men and women. During the 24-hour period, SD (13.4±3.8 vs. 14.6±3.1 mmHg, P = 0.091), CV (0.10±0.03% vs. 0.12±0.2%, P<0.05) and ARV (10.7±3.1 vs. 11.9±2.6 mmHg, P<0.05) of systolic BP were significantly lower in men than in women. Similarly, the variability of diastolic BP over the 24-hour period was numerically lower in men as compared with women (SD: 10.3±2.4 vs. 10.9±2.2 mmHg, P = 0.218; CV: 0.12±0.03% vs. 0.14±0.03%, P<0.05; ARV: 8.4±2.0 vs. 9.0±1.9 mmHg, P = 0.136). These sex differences in indices of short-term BP variability were consistent during both daytime and nighttime periods. Conclusions: The present study shows that among patients undergoing PD, SD, CV and ARV of systolic and diastolic BP are lower in men than in women. Longitudinal studies are needed to explore whether these sex-related differences in short-term BP variability are prognostically informative in the PD population.