Background and aims: Hypertension is a major risk factor for chronic kidney disease (CKD), and CKD progression is associated with suboptimal blood pressure (BP) control. Here we evaluate the impact of CKD on the attainment of BP control and the circadian BP profile in older subjects.Methods: In this observational study, we studied 547 patients referred to the hypertension clinic, of whom 224 (40.9%) had CKD. Blood pressure (BP) control and circadian BP patterns were evaluated by 24-hour ambulatory BP monitoring. Circadian BP variability was measured as the within-subject SD of BP, the percentage of measurements exceeding normal values, hypotension, and dipping status.Results: The attainment of adequate BP control was similar in subjects with or without CKD (around 31%). Logistic regression analysis indicated that CKD was not a determinant of adequate BP control (OR 1.004; 95% CI 0.989-1.019; p = 0.58). Patients with CKD presented as twice as higher prevalence of reverse dipper (night-time peak) for systolic BP and episodes of hypotension during daytime, independently of BP control.Conclusions: Knowledge of the circadian pattern of BP in hypertensive subjects with CKD could inform better than attainment of BP target about risky condition for CKD progression and cognitive decline and allow a more personalized antihypertensive treatment. (C) 2017 Elsevier B.V. All rights reserved.

Di Daniele, N., Fegatelli, D.a., Rovella, V., Castagnola, V., DI MARCO, G., Scuteri, A. (2017). Circadian blood pressure patterns and blood pressure control in patients with chronic kidney disease. ATHEROSCLEROSIS, 267, 139-145 [10.1016/j.atherosclerosis.2017.10.031].

Circadian blood pressure patterns and blood pressure control in patients with chronic kidney disease

Di Daniele, Nicola;Rovella, Valentina;Gabriele, Marco;
2017

Abstract

Background and aims: Hypertension is a major risk factor for chronic kidney disease (CKD), and CKD progression is associated with suboptimal blood pressure (BP) control. Here we evaluate the impact of CKD on the attainment of BP control and the circadian BP profile in older subjects.Methods: In this observational study, we studied 547 patients referred to the hypertension clinic, of whom 224 (40.9%) had CKD. Blood pressure (BP) control and circadian BP patterns were evaluated by 24-hour ambulatory BP monitoring. Circadian BP variability was measured as the within-subject SD of BP, the percentage of measurements exceeding normal values, hypotension, and dipping status.Results: The attainment of adequate BP control was similar in subjects with or without CKD (around 31%). Logistic regression analysis indicated that CKD was not a determinant of adequate BP control (OR 1.004; 95% CI 0.989-1.019; p = 0.58). Patients with CKD presented as twice as higher prevalence of reverse dipper (night-time peak) for systolic BP and episodes of hypotension during daytime, independently of BP control.Conclusions: Knowledge of the circadian pattern of BP in hypertensive subjects with CKD could inform better than attainment of BP target about risky condition for CKD progression and cognitive decline and allow a more personalized antihypertensive treatment. (C) 2017 Elsevier B.V. All rights reserved.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/09
Settore MED/14
English
Ambulatory blood pressure monitoring
Blood pressure
Blood pressure variability
Chronic kidney disease
Aged
Antihypertensive Agents
Blood Pressure Monitoring, Ambulatory
Body Mass Index
Female
Humans
Hypertension
Hypotension
Male
Middle Aged
Prevalence
Regression Analysis
Renal Insufficiency, Chronic
Risk Factors
Sleep
Blood Pressure
Circadian Rhythm
Di Daniele, N., Fegatelli, D.a., Rovella, V., Castagnola, V., DI MARCO, G., Scuteri, A. (2017). Circadian blood pressure patterns and blood pressure control in patients with chronic kidney disease. ATHEROSCLEROSIS, 267, 139-145 [10.1016/j.atherosclerosis.2017.10.031].
Di Daniele, N; Fegatelli, Da; Rovella, V; Castagnola, V; DI MARCO, G; Scuteri, A
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/308716
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