Ambulatory monitoring unmasks hypertension among kidney transplant patients: single center experience and review of the literature

Figures

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  Fig. 1. Distribution and clinical correlates of the clinic-awake BP difference. a Density histograms plotting the distribution of ΔBP values; clinic-awake systolic BP (top) and diastolic BP (bottom). For reference, the respective distributions are shown from an ABPM referral dataset. b Bland-Altman plots of ΔSBP (left) or ΔDBP (right) vs. the respective average of awake and clinic BP. The dotted line represents the mean difference while the dashed lines represent the 95% limits of agreement (±2 standard deviations of the difference) (c) Dependence of ΔSBP on age (top), immuno-suppressive regimen (middle) and the variability of awake SBP (bottom)

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  Fig. 2. Clinic and awake systolic BP in relation to tacrolimus use. a Box plots summarizing clinic and awake SBP levels among patients treated with cyclosporine, tacrolimus or neither calcineurin inhibitor. b, c Lack of relationship was noted between clinic SBP (b) or ambulatory awake SBP (c) and tacrolimus trough levels

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  Fig. 3. Diurnal ambulatory monitoring patterns in relation to calcineurin inhibitor use. Hourly averages (left panels) and 3-h interval averages (right panels) of ambulatory systolic BP (top), diastolic BP (middle) and heart rate (bottom) are plotted according to calcineurin inhibitor use, with bars indicating standard error of the mean. Asterisks (*) denote time points or intervals in which levels were significantly different between tacrolimus and cyclosporine-treated study patients

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  Fig. 4. Rates of clinic vs awake blood pressure patterns. Waffle plots showing the prevalence of blood pressure control patterns among study patients, considering (a) JNC8 clinic hypertension cutoffs, 140/90 mmHg, or (b) KDIGO and ACC-recommended clinic cutoffs, 130/80 mmHg