scholarly journals Comparison of Chronic Hemodialysis Patients under Strict Volume Control with respect to Cardiovascular Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Fadime Ersoy Dursun ◽  
Ali Ihsan Gunal ◽  
Ercan Kirciman ◽  
Ilgin Karaca ◽  
Mustafa Necati Dagli

Background. The objective of this study was to determine the effects of strict volume control and nondipper situation on cardiovascular disease in chronic hemodialysis patients. Methods. This study is an observational and cross-sectional study including 62 patients with normotensive chronic hemodialysis using no antihypertensive drugs. A series of measurements including ambulatory blood pressure monitoring, left ventricular mass index by echocardiography, common carotid artery intima-media thickness by ultrasound, and body fluids by bioimpedance analysis were conducted for all subjects. Results. The patients were divided into two groups as dippers and nondippers according to their ambulatory blood pressure monitoring results. Average 48 h systolic, diastolic, and mean arterial blood pressure and nocturnal systolic, diastolic, and mean arterial blood pressure were significantly different between the dipper and nondipper groups (p<0.05). Before and after dialysis, extracellular fluid/intracellular fluid and extracellular fluid/dry body weight ratios were significantly higher in the nondipper group. Left ventricle mass index and interventricular septum thickness were significantly higher in the nondipper group (p<0.05). Left ventricle ejection fraction was significantly lower and common carotid artery intima-media thickness was higher in the nondipper group with a statistical significance (p<0.05). A two-predictor logistic model was fitted to the data to predict the comparability of dippers and nondippers. Conclusion. According to logistic regression analysis, the odds ratio for daytime diastolic blood pressure indicates that nondippers are 0.45 times more likely to have high blood pressure than dippers in daytime. But in night time, nondippers are about 2.55 times more likely to have high blood pressure comparing to dippers. An important finding of this study is that nondipping pattern is associated with cardiac hypertrophy and lower left ventricle ejection fraction in dialysis of patients with no hypertension. The results also suggest that applying strict volume control to achieve a normal blood pressure alone is not sufficient to reduce the risk of cardiovascular morbidity and mortality if the patients do not have a dipper status of nocturnal blood pressure.

2020 ◽  
Vol 73 (1) ◽  
pp. 46-51
Author(s):  
Tetiana Y. Niushko ◽  
Olena K. Tarasiuk ◽  
Yulia K. Sikalo

The aim: To evaluate the dynamics of structural and functional parameters of the heart, vessels in patients with hypertension of the II-nd stage under the influence of combined antihypertensive treatment depending on the type of the left ventricle remodelling and the profile of blood pressure (BP). Materials and methods: The study involved 110 patients with hypertension of the II-nd stage. The ambulatory blood pressure monitoring, echocardiography and Doppler examination of the shoulder arteries were performed. Initial treatment included bisoprolol, lisinopril, hydrochlorothiazide. With impossibility of BP lowering to the target level, amlodipine has been added. Results: higher levels of BP in the “non-dipper” patients have led to the development of more pronounced changes in the heart and vessels compared with “dipper” patients. Three-component therapy was effective in patients with lower BP. The prescription of amlodipine has been found to be necessary for the majority of “non-dipper” patients and for the minority of “dipper”. Combined therapy effectively controlled the BP at the level of the target and contributed to a decrease in the displays of remodelling of the heart and blood vessels. Conclusions: combined therapy used for 6 months reduces displays of disadaptive heart and vascular remodelling, diastolic, endothelial dysfunction. With the lack of efficacy of the therapy, which includes bisoprolol, lisinopril, hydrochlorothiazide, the adding of amlodipine to it can reach the target level of BP


2002 ◽  
Vol 43 (1) ◽  
pp. 10 ◽  
Author(s):  
Sung Yong Park ◽  
Sou Ouk Bang ◽  
Young Lan Kwak ◽  
Young Jun Oh ◽  
Hyuck Rae Cho ◽  
...  

2019 ◽  
Vol 56 (16) ◽  
pp. 161701
Author(s):  
章小曼 Xiaoman Zhang ◽  
翁存程 Cuncheng Weng ◽  
朱莉莉 Lili Zhu ◽  
蔡坚勇 Jianyong Cai ◽  
吴淑莲 Shulian Wu ◽  
...  

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