Key result
A 44-hour ambulatory blood pressure monitoring pattern with stable BP was associated with significantly better ventricular mass and survival over 30 months compared to rising or high BP patterns.
Why the study?
Does 44-hour ambulatory blood pressure monitoring better predict target organ lesions and survival compared to 24-hour monitoring in hemodialysis patients?
Cohort (n=45)
Does 44-hour ambulatory blood pressure monitoring better predict target organ lesions and survival compared to 24-hour monitoring in hemodialysis patients?
44-hour ambulatory blood pressure monitoring provides more accurate prognostic information regarding target organ damage and survival than 24-hour monitoring in hemodialysis patients.
Supports extended BP monitoring for prognosis in hemodialysis; leaves open whether 44-hour patterns outperform 24-hour assessment.
The aim of this study is to evaluate if hemodialysis (HD) patients with similar blood pressure (BP) in the whole inter-HD period could have different target organ lesions and survival if the behavior of BP differs from the first to the second day of the inter-HD period. The present study compares 44-hour ambulatory BP monitoring (ABPM) patterns in 45 HD patients. Three BP patterns emerged: group A (n = 15) had similar BPs throughout (138 +/- 11/88 +/- 12 in the first 22 h vs. 140 +/- 11/87 +/- 12 mm Hg in the second 22-hour period); group B (n = 15) had a significant systolic BP rise from the first to the second period (132 +/- 15/80 +/- 12 vs. 147 +/- 12/86 +/- 13 mm Hg, p < 0.05); group C (n = 15) had significantly higher BPs (p < 0.05) than the other 2 groups throughout the whole inter-HD period, with no significant change between the 2 halves (172 +/- 14/108 +/- 12 vs. 173 +/- 18/109 +/- 14 mm Hg). Ventricular mass and survival during the 30-month follow-up period were statistically significantly better in group A, intermediate in group B and worse in group C. The data suggest that a 44-hour ABPM is more accurate than a 24-hour one in evaluating organ lesion and prognosis in HD patients.
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Martín et al. (2006) conducted a cohort in Hemodialysis (n=45). 44-hour ambulatory blood pressure monitoring (ABPM) patterns vs. Different BP patterns (stable vs rising vs consistently high) was evaluated on Ventricular mass and survival. A 44-hour ambulatory blood pressure monitoring pattern with stable BP was associated with significantly better ventricular mass and survival over 30 months compared to rising or high BP patterns.
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