Blood Pressure Response to Exercise in Unaffected Relatives of Polycystic Kidney Disease Patients

Background Hypertension is an early finding of autosomal dominant polycystic kidney disease (ADPKD) and is related to different mechanisms. Cyst expansion related renin secretion or early endothelial dysfunctions are some of these hypotheses. Different course of hypertension in ADPKD preoccupies that relatives of ADPKD patients may also be under risk for this underlying mechanisms. In this study, we aimed to find blood pressure response problems to exercise as an initial vascular problem in unaffected relatives of hypertensive ADPKD patients. Methods The cross-sectional study included 24 unaffected relatives (siblings and children) of ADPKD patients and 30 healthy controls that performed a cycle ergometer test. Additionally, as a marker for endothelial function, nitric oxide (NO) and asymmetric dimethylarginine (ADMA) levels at baseline and post exercise were measured. Results Systolic blood pressure (SBP) and diastolic blood pressure (DBP) increases were similar in both groups during the 1st, 3rd, and 6th min of exercise. During the exercise recovery phase SBP decreased in both groups; however, in the relatives of ADPKD patients DBP remained high at the end of the 6th min, suggesting impaired capacity for exercise-induced vasodilatation. Baseline NO and ADMA, and 1-min NO and ADMA were similar in both groups. Conclusion Abnormal blood pressure response to exercise stress was observed in unaffected normotensive relatives. The observed abnormal DBP response pattern to exercise suggests that arterial vascular responses might be already altered in unaffected relatives of hypertensive ADPKD patients; however, long-term clinical trials are needed to clarify the significance of these findings.

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FP160SYSTOLIC BLOOD PRESSURE RESPONSE TO EXERCISE IN UNAFFECTED FAMİLY MEMBERS OF AUTOSOMAL DOMİNANT POLYCYSTİC KİDNEY DİSEASE PATİENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz106.fp160 ◽

2019 ◽

Vol 34 (Supplement_1) ◽

Author(s):

DİDEM TURGUT ◽

Ezgi Yenigun Coskun

Keyword(s):

Blood Pressure ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Autosomal Dominant ◽

Blood Pressure Response ◽

Family Members ◽

Pressure Response ◽

Polycystic Kidney ◽

Autosomal Dominant Polycystic Kidney ◽

Response To Exercise

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Systolic Blood Pressure Response to Exercise Stress Test and Risk of Stroke

Stroke ◽

10.1161/hs0901.095395 ◽

2001 ◽

Vol 32 (9) ◽

pp. 2036-2041 ◽

Cited By ~ 156

Author(s):

S. Kurl ◽

J.A. Laukkanen ◽

R. Rauramaa ◽

T.A. Lakka ◽

J. Sivenius ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Blood Pressure Response ◽

Stress Test ◽

Exercise Stress Test ◽

Pressure Response ◽

Exercise Stress ◽

Response To Exercise

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SO037AMBULATORY BLOOD PRESSURE IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE - IMPROVING DIAGNOSIS AND OPTIMIZING THERAPY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa139.so037 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Magdalena Jankowska ◽

Marek Aniserowicz ◽

Piotr Nowak ◽

Anna Szyndler ◽

Michal Hoffmann ◽

...

Keyword(s):

Blood Pressure ◽

Kidney Disease ◽

Polycystic Kidney Disease ◽

Autosomal Dominant ◽

Masked Hypertension ◽

Polycystic Kidney ◽

Treatment Needs ◽

Cross Sectional ◽

Autosomal Dominant Polycystic Kidney ◽

Cross Sectional Design

Abstract Background and Aims Hypertension (AH) is an early complication of autosomal dominant polycystic kidney disease (ADPKD), which significantly increases the risk of decline of kidney function and impacts cardiovascular risk. The diagnosis of AH is often delayed and the optimal control of blood pressure (BP) is difficult to achieve in this group of patients. Of note, the optimal treatment of AH in ADPKD is yet to be established. Aim of the study was to diagnose AH (including the prevalence of masked hypertension) and to evaluate the control of BP with the use of ABPM in a cohort of ADPKD patients. Method ABPMs were performed in 163 consecutive patients, with ADPKD according to Pei criteria, appointed for the first outpatient visit. Prior to the ABPM, the diagnosis based on office BP or current AH treatment was established as well as age, sex, medication intake, and eGFR (CKD-EPI formula) were recorded. The study had a cross-sectional design. Results Out of 163 performed ABPMs, 143 were eligible for further analysis. The study group consisted of 93 females and 50 males, median age was 40 (18-87) years and median eGFR was 79.5(13-90) ml/min/1.73m2. 68% of patients had CKD G1 or 2. Median systolic blood pressure (SBP) was 127 (101-157) mmHg with blood pressure variability (BPV) 12 (7.8-23); median diastolic blood pressure (DBP) was 79 (58-98) mmHg, BPV 10.8 (6.2-17.4). 35% of patients were non-dippers, 2.7% extreme dippers and 4.9% reverse-dippers. In 31 (55%), out of 56 patients without previous diagnosis of AH, masked hypertension was found. Among 87 diagnosed with AH before the measurement, 49% were treated with 1 drug, and 29% with 2, 13% with 3, and 2% with 4. The most prevalent medication was ACE-inhibitor. Among treated, only 5.5% had all ABPM values within the target. Conclusion 55% of patients previously not diagnosed with AH on the basis of office BP proved to suffer from masked hypertension. The night DBP was the most suboptimally controlled value in ADPKD patients. Whether this is a consequence of nonadherence or suboptimal treatment, needs further investigation. ABPM is an indispensable tool in managing patients inflicted with ADPKD.

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