THE PARTICULARITIES OF ABPM PARAMETERS IN HYPERTENSIVE PATIENTS WITH NON-DIALYSIS CKD

Chronic kidney disease (CKD) affects approximately two million people (in a population of 20 million) in Romania. Hypertension is often associated with CKD and both (hypertension and CKD) are risk factors for cardiovascular (CV) events. Ambulatory blood pressure monitoring (ABPM) is increasingly used all around the world for the diagnosis and monitoring of BP (blood pressure) because it is proven that the ABPM is superior to office BP measurements in evaluating patients with hypertension, with or without CKD. Reduced nocturnal BP fall (non-dipping or reverse-dipping patterns) is associated with target organ damage, especially kidney disease and the proportion of non-dippers and reverse-dippers patients increases progressively with the reduction of glomerular filtration rate (GFR). Another ABPM parameter, ambulatory arterial stiffness index (AASI), is an index which was recently proposed for the evaluation of arterial stiffness (a better tool than PP). It has prognostic value for cardiac death and stroke and several studies have showed that is negatively related to eGFR and is positively related to albuminuria. Hyperbaric area index (HBI) might be considered a novel sensitive marker [independent of patterns of NBPC (nocturnal BP change)] for the reduction of kidney function. These facts suggest that ABPM offers multiple useful data with impact, not only in future CV and renal outcomes assessment, but also in the treatment and management of hypertensive patients with CKD.

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24-Hour Blood Pressure Monitoring: Association Between AASI (Ambulatory Arterial Stiffness Index) and Subclinical Target Organ Damage

High Blood Pressure & Cardiovascular Prevention ◽

10.2165/00151642-200714030-00171 ◽

2007 ◽

Vol 14 (3) ◽

pp. 145-196

Author(s):

F Natale ◽

M A Tedesco ◽

R Calabrò

Keyword(s):

Blood Pressure ◽

Arterial Stiffness ◽

Blood Pressure Monitoring ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Stiffness Index ◽

Pressure Monitoring ◽

Arterial Stiffness Index

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Ambulatory Arterial Stiffness Index Is Higher in Hypertensive Patients with Chronic Kidney Disease

International Journal of Hypertension ◽

10.1155/2012/178078 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Ronaldo Altenburg Gismondi ◽

Mario Fritsch Neves ◽

Wille Oigman ◽

Rachel Bregman

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Arterial Stiffness ◽

Blood Pressure Monitoring ◽

Stiffness Index ◽

Hypertensive Patients ◽

Clinical Endpoints ◽

Mdrd Formula ◽

Arterial Stiffness Index

Ambulatory arterial stiffness index (AASI) is a parameter obtained from ambulatory blood pressure monitoring (ABPM) that correlates with clinical endpoints. The aim of this study was to compare AASI in nondiabetic hypertensive patients with and without chronic kidney disease (CKD). Subjects with systemic arterial hypertension (SAH,n=30) with normal renal function, aged 40 to 75 years, were compared to hypertensive patients with CKD (n=30) presenting estimated glomerular filtration rate (eGFR) <60 mL/min by MDRD formula. ABPM was carried out in all patients. In CKD group, eGFR was 35.3 ± 2.8 ml/min. The mean 24-hour systolic and diastolic blood pressure (BP) was similar in both groups. AASI was significantly higher in CKD group (0.45±0.03versus0.37±0.02,P<0.05), positively correlated to age (r=0.38,P<0.01) and pulse pressure (r=0.43,P<0.01) and negatively correlated to nocturnal BP fall (r=-0.28,P=0.03). These findings indicate the presence of stiffer vessels in CKD hypertensive patients.

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Relationship between ambulatory arterial stiffness index and subclinical target organ damage in hypertensive patients

Hypertension Research ◽

10.1038/hr.2010.195 ◽

2010 ◽

Vol 34 (2) ◽

pp. 180-186 ◽

Cited By ~ 29

Author(s):

Ángel García-García ◽

Manuel A Gómez-Marcos ◽

José I Recio-Rodriguez ◽

Luis J González-Elena ◽

Javier Parra-Sanchez ◽

...

Keyword(s):

Arterial Stiffness ◽

Target Organ Damage ◽

Organ Damage ◽

Target Organ ◽

Stiffness Index ◽

Hypertensive Patients ◽

Arterial Stiffness Index

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Uric Acid Is Not Associated With Blood Pressure Phenotypes and Target Organ Damage According to Blood Pressure Phenotypes

American Journal of Hypertension ◽

10.1093/ajh/hpaa130 ◽

2020 ◽

Author(s):

Anping Cai ◽

Lin Liu ◽

Mohammed Siddiqui ◽

Dan Zhou ◽

Jiyan Chen ◽

...

Keyword(s):

Blood Pressure ◽

Uric Acid ◽

Arterial Stiffness ◽

Blood Pressure Monitoring ◽

Target Organ Damage ◽

Organ Damage ◽

Left Ventricular ◽

Target Organ ◽

Uncontrolled Hypertension ◽

Hypertensive Patients

Abstract BACKGROUND Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24 h-ambulatory blood pressure monitoring (24 h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying uric acid as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24 h-ABPM should be used routinely in hypertensive patients with increased SUA. METHODS To address this knowledge gap, we investigated (i) the correlation between SUA and 24 h-ABP; (ii) the association between SUA and blood pressure (BP) phenotypes (controlled hypertension [CH], white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH], and sustained uncontrolled hypertension [SUCH]); (iii) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH], and arterial stiffness) according to BP phenotypes. RESULTS In 1,336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found (i) there was no correlation between SUA and 24 h, daytime, and nighttime systolic blood pressure/diastolic blood pressure, respectively; (ii) in reference to CH, SUA increase was not associated WCUH (odds ratio [OR] 0.968, P = 0.609), MUCH (OR 1.026, P = 0.545), and SUCH (OR 1.003, P = 0.943); (iii) the overall prevalence of microalbuminuria, LVH, and arterial stiffness was 2.3%, 16.7%, and 23.2%, respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus, and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes. CONCLUSIONS These preliminary findings did not support routine use of 24 h-ABPM in treated hypertensive patients with increased SUA.

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