Home blood pressure monitoring improves the diagnosis of hypertension in hemodialysis patients

Kidney International
Rajiv AgarwalChandan Saha

Abstract

Using interdialytic ambulatory blood pressure (BP) recordings as the reference standard, we compared the performance of routine, standardized and home BP monitoring in 104 predominantly black patients on chronic hemodialysis for at least 3 months. Dialysis unit BP recordings were averaged over 2 weeks and home BP over 1 week. Awake ambulatory BP of > or =135 mmHg systolic or > or =85 mmHg diastolic was taken as evidence of hypertension. Average awake ambulatory BP was 128.1+/-21.6/73.5+/-13.5 mmHg, home BP 141.3+/-21.9/78.7+/-11.9 mmHg, standardized pre-dialysis BP 141.7+/-22.6/74.2+/-13.5 mmHg and post-dialysis 119.9+/-20.5/69.1+/-13.1 mmHg, routine pre-dialysis 145.4+/-21.8/79.0+/-13.1 mmHg and post-dialysis 131.5+/-19.2/72.5+/-11.4 mmHg. Sixty-three percent of the patients had well-controlled BP by ambulatory BP monitoring and isolated diastolic hypertension was rare (3%). The standard deviation of the differences between ambulatory and routine pre-dialysis BP was 17.6 mmHg, routine post-dialysis was 16.1 mmHg, standardized pre-dialysis was 16.4 mmHg, standardized post-dialysis was 14.1 mmHg, and home BP was 14.2 mmHg. The area under receiver operating characteristic curves was similar for home and standardized BP but lower ...Continue Reading

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Citations

Aug 7, 2012·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Yutaka ImaiUNKNOWN Japanese Society of Hypertension Committee for Guidelines for Self-monitoring of Blood Pressure at Home
Nov 17, 2010·Nature Reviews. Nephrology·Suneel UdaniGeorge L Bakris
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Nov 27, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Sangeetha SatyanRajiv Agarwal
Jun 30, 2006·Hemodialysis International·Rajiv Agarwal

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