Systolic hypertension, widened pulse pressure, and nondipping are predictors of mortality in hemodialysis patients, suggesting blood pressure control focusing on systolic pressure is a prudent strategy.
Does blood pressure control with a focus on systolic pressure improve cardiovascular outcomes in chronic hemodialysis patients?
Blood pressure control with a focus on systolic pressure appears to be a prudent strategy to improve cardiovascular outcomes in hemodialysis patients.
Cardiovascular disease is a leading cause of morbidity and mortality in chronic hemodialysis patients. Most patients with chronic kidney disease have hypertension and its prevalence remains high following renal replacement therapy. Early studies suggested that hypertension was a risk factor for total and cardiovascular mortality in chronic hemodialysis patients, but the results of more recent studies have caused experts to question these assertions. Systolic hypertension, widened pulse pressure, and nondipping may be better predictors of mortality compared to diastolic hypertension or increased mean arterial pressure. Hypertension in hemodialysis patients is a risk factor for left ventricular hypertrophy (LVH), diastolic dysfunction, and congestive heart failure; good blood pressure control may promote its regression. Atherosclerosis and ventricular arrhythmias may also be linked to hypertension. Thus blood pressure control with a focus on systolic pressure appears to be a prudent strategy to improve cardiovascular outcomes in hemodialysis patients.
Birchem et al. (Thu,) conducted a review in Hypertension in chronic hemodialysis patients. Hypertension was evaluated on Cardiovascular outcomes and mortality. Systolic hypertension, widened pulse pressure, and nondipping are predictors of mortality in hemodialysis patients, suggesting blood pressure control focusing on systolic pressure is a prudent strategy.
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