title: Blood pressure measurements and carotid intima media thickness in hemodialysis patients.
abstract: In hemodialysis (HD) patients, routine dialysis center blood pressure (BP) measurements may be a poor indicator of BP control. Ambulatory blood pressure monitoring (ABPM) improves the predictability of BP as a risk factor for target organ damage. Carotid intima-media thickness (IMT) is an important indicator of asymptomatic atherosclerosis and a predictor of cardiovascular events. The purpose of our study was to evaluate the possible association between different BP measurements and carotid IMT in HD patients. Eighty-five HD patients were included in our study. BP was measured with a standard mercury sphygmomanometer before and after each HD session. The average one-monthly values of routine BP measurements were also analyzed. 24- and 48-h ABPM was performed after the end of each HD session using non-invasive ABPM. The average values of systolic and diastolic BP were analyzed separately for the first (HD) and second (interdialytic) days ABPM, and for both days together. Using B-mode ultrasonography, carotid IMT was measured and plaque occurrence investigated. We found a statistically significant correlation between carotid IMT and the average one-monthly pre-HD diastolic BP (P < 0.05), diastolic BP on the HD-day ABPM, the interdialytic-day ABPM, and during 48-h ABPM (P < 0.05). By multiple regression analysis, we found a statistically significant correlation only between carotid IMT and diastolic BP on the HD-day ABPM, the interdialytic-day ABPM, and during 48-h ABPM (P < 0.05). Only longer BP measurements (24- and 48-h ABPM) were associated with carotid IMT in HD patients.
authors.affiliation: Department of Dialysis, Clinic for Internal Medicine, University Medical Center Maribor, SI-2000 Maribor, Slovenia. robert.ekart2@guest.arnes.si
authors.forename: Robert
authors.initials: R
authors.lastname: Ekart
authors.forename: Radovan
authors.initials: R
authors.lastname: Hojs
authors.forename: Breda
authors.initials: B
authors.lastname: Pecovnik-Balon
authors.forename: Sebastjan
authors.initials: S
authors.lastname: Bevc
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dvorsak
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult