scholarly journals Associations Between Day-by-Day Home Blood Pressure Variability and Renal Function and Albuminuria in Patients With and Without Diabetes

2020 ◽  
Vol 33 (9) ◽  
pp. 860-868
Author(s):  
Daisuke Suzuki ◽  
Satoshi Hoshide ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Home Blood Pressure ◽  
Diabetes Group ◽  
Urine Albumin ◽  
Blood Pressure Study ◽  
Average Real Variability ◽  
Day By Day

Abstract BACKGROUND The phenotype of diabetic kidney disease represents a lower estimated glomerular filtration rate (eGFR) and albuminuria. We investigated the association between day-by-day home blood pressure (BP) variability and the eGFR in subjects with diabetes and compared this association with that in subjects without diabetes. We then attempted to determine whether the association is present in albuminuria. METHODS We analyzed 4,231 patients with risk factors of cardiovascular disease (24.4% with diabetes) from the J-HOP (Japan Morning Surge-Home Blood Pressure) study. Home BP was measured in the morning and evening for 14 days. We calculated the SD, coefficient of variation, average real variability (ARV), and variation independent of the mean of the subjects’ morning and evening home systolic BP (SBP) as the indexes of day-by-day home BP variability. RESULTS A multiple linear regression analysis adjusted for covariates showed both average morning and evening SBP were associated with the log-transformed urine albumin-to-creatinine ratio (UACR) with and without diabetes (all P < 0.05), but not with the eGFR except for an association of average evening SBP in the no-diabetes group. None of the indexes of day-by-day morning and evening home SBP variability were associated with the log-transformed UACR except for the association between the ARV of home morning SBP in the diabetes group. All of the indexes of day-by-day morning and evening home SBP variability were associated with the eGFR only in the diabetes group (all P < 0.05). CONCLUSIONS The association between increased day-by-day home BP variability and impaired renal function was unique in diabetes.

Synchronous Telehealth Services with Digital Platform Decreases Day-by-Day Home Blood Pressure Variability in Patients with Cardiovascular Diseases: Retrospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Ying-Hsien Chen ◽  
Chi-Sheng Hung ◽  
Ching-Chang Huang ◽  
Jen-Kuang Lee ◽  
Jiun-Yu Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Disease Burden ◽  
Home Blood Pressure ◽  
University Hospital ◽  
Fourth Generation ◽  
Free Survival ◽  
Telehealth Intervention ◽  
Average Real Variability ◽  
Day By Day

BACKGROUND Hypertension is associated with a large global disease burden with variable controlled rate across different regions and races. Telehealth has recently emerged as a healthcare strategy for managing chronic diseases, but there have been few reports regarding the effects of synchronous telehealth services on home blood pressure (BP) control and variability. OBJECTIVE This study aimed to investigate the effect of fourth-generation synchronous telehealth services on home blood pressure. METHODS This retrospective study was conducted by the TELEHEALTH study group at the Telehealth Center in National Taiwan University Hospital. We analyzed home BP data taken from 2,888 cardiovascular disease patients who were enrolled in our telehealth program and received telehealth services between 2009 and 2017. Mean, standard deviation (SD), coefficient variability (CV), and average real variability (ARV) were calculated. RESULTS A total of 398 patients who underwent constant home BP surveillance for ≥ 2 months were recruited for this study. Patients were stratified into three groups: (1) Poorly-controlled hypertension, (2) Well-controlled hypertension, and (3) Non-hypertension. Telehealth significantly reduced systolic BP in the poorly-controlled hypertension group from 145.2±9.3 mmHg to 132.8±10.3 mmHg after 2 months (P<.001). BP variability was reduced in all patients: SBP-SD decreased from 7.7±3.4 to 7.1±3.2 after 2 months (P<.001), and SBP-CV decreased from 6.2±2.5 to 5.7±2.4 after 2 months (P<.001). Event free survival (admission) analysis stratified by SBP-SD showed longer time to first hospitalization for Q1 patients compared with Q4 patients (P=.04). CONCLUSIONS Synchronous telehealth intervention may improve home BP control and decrease day-by-day home BP variability in patients with cardiovascular disease.

scholarly journals Donor Smoking Negatively Affects Donor and Recipient Renal Function following Living Donor Nephrectomy

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jonathan Heldt ◽  
Robert Torrey ◽  
Daniel Han ◽  
Pedro Baron ◽  
Christopher Tenggardjaja ◽  
...  
Keyword(s):  
Renal Function ◽  
Patient Survival ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Tobacco Exposure ◽  
Kidney Donor ◽  
Chi Square ◽  
Living Donor Nephrectomy ◽  
Percent Increase ◽  
Percent Decrease

Background.While tobacco use by a renal transplant recipient has been shown to negatively affect graft and patient survival, the effect of smoking on the part of the kidney donor remains unknown.Methods.29 smoking donors (SD) and their recipients (SD-R) as well as 71 non-smoking donors (ND) and their recipients (ND-R) were retrospectively reviewed. Preoperative demographics and perioperative variables including serum creatinine (Cr) and glomerular filtration rate (GFR) were calculated and stratified by amount of tobacco exposure in pack-years. Clinical outcomes were analyzed with a Student'st-test, chi-square, and multiple linear regression analysis ().Results.At most recent followup, SD-R's had a significantly smaller percent decrease in postoperative Cr than ND-R's (−57% versus −81%; ) and lower calculated GFR's (37.0 versus 53.0 mL/min per 1.73 m2; . SD's had a larger percent increase in Cr than ND's at most recent followup (57% versus 40%; ), with active smokers having a larger increase than those who quit, although this difference was not statistically significant (68% versus 52%; ).Conclusions.Use of tobacco by kidney donors is associated with decreased posttransplant renal function, although smoking cessation can improve outcomes. Kidneys from donors who smoke should be used with caution.

Evaluation of day-by-day variability of home blood pressure using a home blood pressure telemonitoring system

2016 ◽  
Vol 21 (3) ◽  
pp. 184-188 ◽  
Author(s):  
Toshiki Kaihara ◽  
Kazuo Eguchi ◽  
Satoshi Hoshide ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Home Blood Pressure ◽  
Day By Day

Value of Morning Home Blood Pressure as a Predictor of Decline in Renal Function in Patients with Chronic Kidney Disease

2008 ◽  
Vol 28 (6) ◽  
pp. 982-989 ◽  
Author(s):  
Tomonari Okada ◽  
Toshiyuki Nakao ◽  
Hiroshi Matsumoto ◽  
Yume Nagaoka
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Home Blood Pressure

scholarly journals Decreased renal function increases the nighttime urine volume rate by carryover of salt excretion to the nighttime

2021 ◽  
Author(s):  
Kentaro Takezawa ◽  
Sohei Kuribayashi ◽  
Koichi Okada ◽  
Yosuke Sekii ◽  
Yusuke Inagaki ◽  
...  
Keyword(s):  
Renal Function ◽  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Excretion Rate ◽  
Linear Regression Analysis ◽  
Urine Volume ◽  
Multiple Linear Regression Analysis ◽  
Volume Rate ◽  
Salt Excretion

Abstract Purpose: To determine the pathophysiology of nocturnal polyuria associated with renal dysfunction.Methods: Patients who underwent laparoscopic nephrectomy were studied prospectively. The diurnal variation in urine volume, osmolality, and salt excretion were measured on preoperative day two and postoperative day seven. The factors associated with an increase in the nighttime urine volume rate with decreased renal function were evaluated by multiple linear regression analysis.Results: Forty-nine patients were included. The eGFR decreased from 73.3 ± 2.0 to 47.2 ± 1.6 mL/min/1.73 m2 (P < 0.01) and the nighttime urine volume rate increased from 40.6% ± 2.0% to 45.3% ± 1.5% (P = 0.04) with nephrectomy. The nighttime urine osmolality decreased from 273 ± 15 to 212 ± 10 mOsm/kg (P < 0.01) and the nighttime salt excretion rate increased from 38.7% ± 2.1% to 48.8% ± 1.7% (P < 0.01) with nephrectomy. Multiple linear regression analysis revealed that the increase in the nighttime urine volume rate was strongly affected by the increase in the nighttime salt excretion rate.Conclusion: A decrease in renal function causes an increase in the nighttime urine volume rate, mainly due to an increase in nighttime salt excretion.Trial registration number: UMIN000036760 (University Hospital Medical Information Network Clinical Trials Registry)Date of registration: From June 1st, 2019 to October 31th 2020

scholarly journals Comparison of Blood Pressure Variability Between Losartan and Amlodipine in Essential Hypertension (COMPAS-BPV)

2020 ◽  
Vol 33 (8) ◽  
pp. 748-755
Author(s):  
Jun-Won Lee ◽  
Eunhee Choi ◽  
Jung-Woo Son ◽  
Young Jin Youn ◽  
Sung-Gyun Ahn ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Variability ◽  
Renin Angiotensin System ◽  
Office Visit ◽  
Home Blood Pressure ◽  
Channel Blockers ◽  
Hypertensive Patients ◽  
Amlodipine Group ◽  
Losartan Group ◽  
Average Real Variability

Abstract BACKGROUND Antihypertensive therapy using renin–angiotensin system blockers and calcium channel blockers to target blood pressure variability (BPV) has not yet been established. We aimed to compare the ability of losartan and amlodipine to lower BPV and systolic blood pressure (SBP) in essential hypertensive patients. METHODS Patients were randomly assigned either losartan 50 mg or amlodipine 5 mg. Medications were uptitrated and hydrochlorothiazide was added according to protocol for 6 months. The primary endpoint was the office visit-to-visit SD of SBP. The secondary endpoints included average real variability (ARV), office SBP, and home SBP. RESULTS The losartan group (n = 71) and amlodipine group (n = 73) finished the scheduled visits between April 2013 and May 2017. The office visit-to-visit SD of SBP was comparable between the losartan and amlodipine groups (11.0 ± 4.2 vs. 10.5 ± 3.8, P = 0.468). The office visit-to-visit ARV of SBP was significantly elevated in the losartan group (10.6 ± 4.3 vs. 9.1 ± 3.4, P = 0.02). The absolute SBP decrement from baseline to 6 months was similar between groups, although the office mean SBP at 6 months was higher in the losartan group (132.3 ± 12.9 vs. 127.5 ± 9.0 mm Hg, P = 0.011). In home blood pressure analysis, evening day-to-day BPV indexes (SD and ARV) were significantly higher in the losartan group at 6 months. CONCLUSIONS The lowering effect of the office visit-to-visit SD of SBP was similar between losartan and amlodipine. However, the losartan group showed a higher office visit-to-visit ARV of SBP and evening day-to-day home BPV indexes. Therefore, amlodipine may be better to lower BPV in essential hypertensive patients.

scholarly journals Determinants of the Morning-Evening Home Blood Pressure Difference in Treated Hypertensives: The HIBA-Home Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lucas S. Aparicio ◽  
Jessica Barochiner ◽  
Paula E. Cuffaro ◽  
José Alfie ◽  
Marcelo A. Rada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Total Cholesterol ◽  
Calcium Channel Blockers ◽  
Target Organ Damage ◽  
Linear Regression Analysis ◽  
Home Blood Pressure ◽  
Channel Blockers ◽  
Analysis Model ◽  
Home Based

Background. The morning home blood pressure (BP) rise is a significant asymptomatic target organ damage predictor in hypertensives. Our aim was to evaluate determinants of home-based morning-evening difference (MEdiff) in Argentine patients.Methods. Treated hypertensive patients aged≥18 years participated in a cross-sectional study, after performing home morning and evening BP measurement. MEdiff was morning minus evening home average results. Variables identified as relevant predictors were entered into a multivariable linear regression analysis model.Results. Three hundred sixty-seven medicated hypertensives were included. Mean age was 66.2 (14.5), BMI 28.1 (4.5), total cholesterol 4.89 (1.0) mmol/L, 65.9% women, 11.7% smokers, and 10.6% diabetics. Mean MEdiff was 1.1 (12.5) mmHg systolic and 2.3 (6.1) mmHg diastolic, respectively. Mean self-recorded BP was 131.5 (14.1) mmHg systolic and 73.8 (7.6) mmHg diastolic, respectively. Mean morning and evening home BPs were 133.1 (16.5) versus 132 (15.7) systolic and 75.8 (8.4) versus 73.5 (8.2) diastolic, respectively. Significant beta-coefficient values were found in systolic MEdiff for age and smoking and in diastolic MEdiff for age, smoking, total cholesterol, and calcium-channel blockers.Conclusions. In a cohort of Argentine medicated patients, older age, smoking, total cholesterol, and use of calcium channel blockers were independent determinants of home-based MEdiff.

Sign in / Sign up

Export Citation Format

Share Document