Key result
Ambulatory blood pressure monitoring revealed discordance with office BP in 61% of renal transplant recipients, with mean systolic BP 3.6 mm Hg (95% CI 0.5-6.5) higher via ABPM.
Why the study?
Does ambulatory blood pressure monitoring improve blood pressure assessment compared to office blood pressure monitoring in renal transplant recipients?
Observational (n=98)
Does ambulatory blood pressure monitoring improve blood pressure assessment compared to office blood pressure monitoring in renal transplant recipients?
Mean Difference: 3.6 (95% CI 0.5–6.5)
Ambulatory blood pressure monitoring reveals significant masked hypertension in renal transplant recipients, leading to management changes in 42% of patients.
ABPM may reveal higher BP than office readings in renal transplant recipients; leaves open whether routine use improves outcomes.
Hypertension is common following renal transplantation and has adverse effects on cardiovascular and graft health. Ambulatory blood pressure monitoring (ABPM) is better at overall blood pressure (BP) assessment and is necessary to diagnose nocturnal hypertension, which is also implicated in poor outcomes. The authors performed a retrospective analysis of 98 renal transplant recipients (RTRs) and compared office BP and ambulatory BP recordings. ABPM revealed discordance between office BP and ambulatory BP in 61% of patients, with 3% caused by white-coat and 58% caused by masked hypertension (of which 33% were caused by isolated nocturnal hypertension). Overall, mean systolic BP was 3.6 mm Hg (0.5-6.5) and diastolic BP was 7.5 mm Hg (5.7-9.3) higher via ambulatory BP than office BP. This was independent of estimated glomerular filtration rate, proteinuria, transplant time/type, and comorbidities. A total of 42% of patients had their management changed after results from ABPM. ABPM should be routinely offered as part of hypertension management in RTRs.
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Ahmed et al. (2014) conducted an observational in Hypertension in renal transplant recipients (n=98). Ambulatory blood pressure monitoring vs. Office blood pressure monitoring was evaluated on Mean systolic blood pressure difference (MD 3.6 mm Hg, 95% CI 0.5-6.5). Ambulatory blood pressure monitoring revealed discordance with office BP in 61% of renal transplant recipients, with mean systolic BP 3.6 mm Hg (95% CI 0.5-6.5) higher via ABPM.
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