Diagnostic and prognostic yields of ambulatory blood pressure measurements in haemodialysis patients: a 6-year longitudinal study.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Acta cardiologica Pub Date : 2024-12-07 DOI:10.1080/00015385.2024.2436811
J Huart, P Vanderweckene, L Seidel, C Bovy, P Delanaye, B Dubois, S Grosch, P Xhignesse, A Saint-Remy, Krzesinski J-M, F Jouret
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Abstract

Background: Blood pressure (BP) control in haemodialysis (HD) patients is essential. Peri-dialytic BP levels do not accurately diagnose hypertension or predict the cardiovascular (CV) mortality.

Methods: In this study, we recruited 43 adult patients who had been on chronic HD for ≥3 months. Seven-day home BP monitoring (HBPM) (values of Day1 discarded) and 44-h interdialytic ambulatory BP monitoring (iABPM) were performed. Pre- and post-dialysis BP levels were measured during the 6 dialysis sessions prior to iABPM. A 6-year follow-up was carried out to assess all-cause and CV mortality.

Results: In patients considered as normotensive in pre-dialysis (n = 17), masked hypertension was found in 24% and 29% on the basis of iABPM and HBPM, respectively. Conversely, among hypertensive patients in pre-dialysis (n = 26), 'white-coat' hypertension was noted in 23% either by iABPM or HBPM. After a 6-year follow-up, 25 patients were deceased including 6 patients from CV causes. Day-time systolic BP measured by iABPM was associated with all-cause mortality in an adjusted model for age and gender (p = 0.045).

Conclusion: In chronic HD patients, 44-h iABPM and 6-day HBPM show a reliable concordance and help to re-classify ∼25% of cases miscategorised based on pre-dialysis measurements. Day-time systolic BP levels using iABPM were significantly associated with 6-year all-cause mortality.

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血液透析患者动态血压测量的诊断和预后:一项为期6年的纵向研究。
背景:控制血液透析(HD)患者的血压(BP)至关重要。透析期血压水平不能准确诊断高血压或预测心血管(CV)死亡率。方法:在这项研究中,我们招募了43名慢性HD≥3个月的成年患者。进行7天家庭血压监测(HBPM)(丢弃第1天的值)和44小时透析间期动态血压监测(iABPM)。在iABPM之前的6次透析期间测量透析前和透析后的血压水平。进行了6年的随访以评估全因死亡率和CV死亡率。结果:在透析前血压正常的患者(n = 17)中,根据iABPM和HBPM分别有24%和29%的患者发现了隐蔽性高血压。相反,在透析前的高血压患者中(n = 26), 23%的iABPM或HBPM显示“白大褂”高血压。经过6年的随访,25例患者死亡,其中6例患者死于心血管疾病。在年龄和性别校正模型中,iABPM测量的白天收缩压与全因死亡率相关(p = 0.045)。结论:在慢性HD患者中,44-h iABPM和6天HBPM显示出可靠的一致性,并有助于重新分类~ 25%基于透析前测量错误分类的病例。使用iABPM的日间收缩压水平与6年全因死亡率显著相关。
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来源期刊
Acta cardiologica
Acta cardiologica 医学-心血管系统
CiteScore
2.50
自引率
12.50%
发文量
115
审稿时长
2 months
期刊介绍: Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.
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