Effects of enhanced versus reduced vasodilating treatment on brachial and central blood pressure in patients with chronic kidney disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dinah Sherzad Khatir ◽  
Rasmus Kirkeskov Carlsen ◽  
Per Ivarsen ◽  
Bente Jespersen ◽  
Michael Pedersen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Central Blood Pressure

scholarly journals Aortic Calcification Affects Noninvasive Estimates of Central Blood Pressure in Patients with Severe Chronic Kidney Disease

2019 ◽  
Vol 44 (4) ◽  
pp. 704-714 ◽  
Author(s):  
Rasmus Kirkeskov Carlsen ◽  
Simon Winther ◽  
Christian D. Peters ◽  
Esben Laugesen ◽  
Dinah S. Khatir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Calcium Score ◽  
Mean Difference ◽  
Aortic Calcification ◽  
Ct Scans ◽  
Central Blood Pressure ◽  
Non Invasive ◽  
Ckd Stage

Background: Central blood pressure (BP) assessed noninvasively considerably underestimates true invasively measured aortic BP in chronic kidney disease (CKD) patients. The difference between the estimated and the true aortic BP increases with decreasing estimated glomerular filtration rates (eGFR). The present study investigated whether aortic calcification affects noninvasive estimates of central BP. Methods: Twenty-four patients with CKD stage 4–5 undergoing coronary angiography and an aortic computed tomography scan were included (63% males, age [mean ± SD ] 53 ± 11 years, and eGFR 9 ± 5 mL/min/1.73 m2). Invasive aortic BP was measured through the angiography catheter, while non-invasive central BP was obtained using radial artery tonometry with a SphygmoCor® device. The Agatston calcium score (CS) in the aorta was quantified on CT scans using the CS on CT scans. Results: The invasive aortic systolic BP (SBP) was 152 ± 23 mm Hg, while the estimated central SBP was 133 ± 20 mm Hg. Ten patients had a CS of 0 in the aorta, while 14 patients had a CS >0 in the aorta. The estimated central SBP was lower than the invasive aortic SBP in patients with aortic calcification compared to patients without (mean difference 8 mm Hg, 95% CI 0.3–16; p = 0.04). The brachial SBP was lower than the aortic SBP in patients with aortic calcification compared to patients without (mean difference 10 mm Hg, 95% CI 2–19; p = 0.02). Conclusion: In patients with advanced CKD the presence of aortic calcification is associated with a higher difference between invasively measured central aortic BP and non-invasive estimates of central BP as compared to patients without calcifications.

2.5 COMPARISON OF NON-INVASIVE AND INVASIVE MEASUREMENTS OF CENTRAL BLOOD PRESSURE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2014 ◽  
Vol 8 (4) ◽  
pp. 124
Author(s):  
R. Carlsen ◽  
C. Peters ◽  
D. Khatir ◽  
E. Laugesen ◽  
S. Winther ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Central Blood Pressure ◽  
Non Invasive

[PS 08-42] ASSOCIATION OF CENTRAL BLOOD PRESSURE WITH MARKERS FOR TARGET ORGAN DAMAGE IN CHRONIC KIDNEY DISEASE PATIENTS

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e304
Author(s):  
Youn Kyung Kee ◽  
Chan-Yun Yoon ◽  
Seohyun Park ◽  
Jung Tak Park ◽  
Seung Hyeok Han ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Central Blood Pressure

scholarly journals Integrated central blood pressure–aortic stiffness risk score for cardiovascular risk stratification in chronic kidney disease

2018 ◽  
Vol 105 (4) ◽  
pp. 335-346 ◽  
Author(s):  
J Nemcsik ◽  
Á Tabák ◽  
D Batta ◽  
O Cseprekál ◽  
J Egresits ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Risk Score ◽  
Aortic Stiffness ◽  
Central Blood Pressure ◽  
Central Systolic Blood Pressure ◽  
Very High ◽  
Risk Categories

Background and aims The aim of this study was to develop an integrated central blood pressure–aortic stiffness (ICPS) risk score to predict cardiovascular events. Methods It was a retrospective cohort study. A total of 100 chronic kidney disease (CKD) patients on conservative therapy were included. Pulse wave velocity (PWV), central systolic blood pressure (cSBP), and central pulse pressure (cPP) were measured. A score was assigned to tertiles of PWV (0–2), cPP (0–2), and cSBP (0 to the first and second and 1 to the third tertile) based on each parameter’s ability to individually predict cardiovascular outcome. The sum of these scores and three ICPS risk categories as predictors were studied. Finally, we compared discrimination of the ICPS risk categories with PWV, cSBP, and cPP. Results Adjusted for age and sex, patients in high and very high ICPS risk categories had increased cardiovascular risk (HR: 3.52, 95% CI: 1.65–7.49; HR: 7.56, 95% CI: 3.20–17.85, respectively). High and very high ICPS risk categories remained independent predictors in a model adjusted for multiple CV risk factors (HR: 4.58, 95% CI: 1.65–7.49; HR: 8.56, 95% CI: 3.09–23.76, respectively). ICPS risk categories (Harrell’s C: 0.723, 95% CI: 0.652–0.795) showed better discrimination than PWV (Harrell’s C: 0.659, 95% CI: 0.586–0.732, p = 0.028) and cSBP (Harrell’s C: 0.660, 95% CI: 0.584–0.735, p = 0.008) and there has been a tendency of significance in case of cPP (Harrell’s C: 0.691, 95% CI: 0.621–0.761, p = 0.170). Conclusion The ICPS score may clinically importantly improve the identification of CKD patients with elevated cardiovascular risk.

11.7 AORTIC CALCIUM SCORE AFFECTS NON-INVASIVELY OBTAINED ESTIMATES OF CENTRAL BLOOD PRESSURE IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE

2016 ◽  
Vol 16 (C) ◽  
pp. 76
Author(s):  
Rasmus K. Carlsen ◽  
Christian D. Peters ◽  
Esben Laugesen ◽  
Simon Winther ◽  
Dinah S. Khatir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Calcium Score ◽  
Central Blood Pressure ◽  
Advanced Chronic Kidney Disease

scholarly journals Aldosterone breakthrough does not alter central hemodynamics

2017 ◽  
Vol 18 (4) ◽  
pp. 147032031773500
Author(s):  
Andrew Beenken ◽  
Andrew S. Bomback
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Congestive Heart Failure ◽  
Kidney Disease ◽  
Central Blood Pressure ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Aldosterone Breakthrough ◽  
Peripheral Blood Pressure

Introduction: Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are widely used in congestive heart failure and chronic kidney disease, but up to 40% of patients will experience aldosterone breakthrough, with aldosterone levels rising above pre-treatment levels after 6–12 months of renin-angiotensin-aldosterone system blockade. Aldosterone breakthrough has been associated with worsening congestive heart failure and chronic kidney disease, yet the pathophysiology remains unclear. Breakthrough has not been associated with elevated peripheral blood pressure, but no studies have assessed its effect on central blood pressure. Methods: Nineteen subjects with well-controlled peripheral blood pressure on stable doses of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker had aldosterone levels checked and central blood pressure parameters measured using the SphygmoCor system. The central blood pressure parameters of subjects with or without breakthrough, defined as serum aldosterone >15 ng/dl, were compared. Results: Of the 19 subjects, six had breakthrough with a mean aldosterone level of 33.8 ng/dl, and 13 were without breakthrough with a mean level of 7.1 ng/dl. There was no significant difference between the two groups in any central blood pressure parameter. Conclusions: We found no correlation between aldosterone breakthrough and central blood pressure. The clinical impact of aldosterone breakthrough likely depends on its non-genomic, pro-fibrotic, pro-inflammatory effects rather than its regulation of extracellular volume.

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