title: Analysis of factors that affect short-term blood pressure variability in patients with chronic renal failure.
abstract: Recent reports suggest the relationship of short-term blood pressure (BP) variability to cardiovascular target organ damage. In this study, short-term BP variability was assessed as the standard deviation of daytime and nighttime BP in 36 hospitalized patients with chronic renal failure (CRF) who underwent ambulatory BP monitoring. Positive correlations were observed between body mass index (BMI) and daytime systolic and diastolic BP variability, BMI and nighttime diastolic BP variability, cholesterol and daytime systolic BP variability, cholesterol and nighttime systolic and diastolic BP variability, nocturnal decline in BP and nighttime diastolic BP variability, and plasma concentration of norepinephrine (p-NE) and nighttime systolic BP variability. In multivariate linear regression analyses, BMI showed the strongest association with daytime and nighttime diastolic BP variability (p < .005 and p < .05). On the other hand, cholesterol and p-NE were the primary determinants of daytime and nighttime systolic BP variability, respectively (p < .01 and p < .0005). Interestingly, CRF patients with ischemic heart disease (IHD) had significantly increased daytime systolic and diastolic BP variability and nighttime systolic BP variability (p < .05 or less). Furthermore, logistic regression analysis demonstrated that nighttime systolic BP variability was an independent risk factor of IHD in patients with CRF (odds ratio 1.50 [95% confidence interval 1.01 to 2.25]; p < .05). Taken together, short-term BP variability is suggested to be affected by BMI, cholesterol, and p-NE in CRF patients. Furthermore, sympathetic nerve overactivity may be involved in cardiovascular complications in CRF patients through the increase in nighttime systolic BP variability.
authors.affiliation: Department of Medicine II, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakai
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tsurumi
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Okano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Koide
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Endoh
authors.forename: Kei
authors.initials: K
authors.lastname: Matsushita
authors.forename: Minoru
authors.initials: M
authors.lastname: Kihara
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Hirawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Toya
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tokita
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Ohnishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D009638:Norepinephrine / Q000097:blood; D016017:Odds Ratio; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002784:Cholesterol; D009638:Norepinephrine