Arterial blood pressure and left ventricular hypertrophy in haemodialysis patients.
OBJECTIVE
To test the hypothesis that there is an association between arterial blood pressure and left ventricular hypertrophy and patterns of ventricular geometry, defined echocardiographically, in a group of stable haemodialysis patients with a low prevalence of extrarenal diseases.


METHODS
Patients with end-stage renal failure treated by regular haemodialysis (aged 44.3 +/- 12.9 years, n = 103, among whom 52 men and 23 blacks, dialysis duration 49.8 +/- 35.3 months) were subjected to echocardiographic evaluation (M-mode, bidimensional and Doppler) on the day preceding dialysis. The average of all predialysis blood pressure determinations during the 3 months preceding the tests (34-38 determinations in each patient) were used as baseline data. Univariate and multivariate tests were used to assess the main variables associated with echocardiographically defined cardiac alterations and with patterns of ventricular geometry.


RESULTS
The systolic blood pressure was significantly associated with the left ventricular mass index and was significantly and independently correlated with left ventricular hypertrophy, posterior wall hypertrophy, left ventricle dilation and increased relative wall thickness. Other significant correlations were between the haematocrit level and left ventricular hypertrophy and between age and altered systolic and diastolic functions. Concentric ventricular hypertrophy was observed only in patients with a history of hypertension, whereas the prevalence of normal geometry was higher in patients without a history of hypertension.


CONCLUSIONS
The systolic blood pressure is an important factor influencing the occurrence of left ventricular hypertrophy in haemodialysis patients and also affects the left ventricle geometry in this population.
de Lima
J J
JJ
Hypertension Unit, São Paulo University Medical School, Brazil.
Abensur
H
H
Krieger
E M
EM
Pileggi
F
F
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis