title: Seasonal variations of daily changes in blood pressure among hypertensive patients with end-stage renal diseases.
abstract: Hypertension is a well-known cardiovascular risk. Patients with end-stage renal diseases frequently suffer hypertension, and their blood pressure elevates in winter. However, seasonal changes in daily variations of blood pressure are poorly assessed in patients treated with hemodialysis. Thirty hypertensive patients with end-stage renal diseases were enrolled in the study. Dry weight and antihypertensive medications were altered when they were necessary. Home blood pressure measurements were performed at least for 1 week in each season; April-May 2008, July-August 2008, October-November 2008, and January-February 2009. Both morning and evening systolic blood pressures (SBPs) showed significant seasonal changes ( p < 0.01), with the highest blood pressure in winter (162 +/- 18 and 135 +/- 22 mmHg in morning and evening). Morning diastolic blood pressure (DBP) also exhibited seasonal changes ( p < 0.05), with the highest blood pressure in fall ( 78 +/- 8 mmHg). Evening DBP did not manifest seasonal deviations. Morning-evening differences in SBP and DBP were the greatest in winter (28 +/- 21 and 10 +/- 9 mmHg in SBP and DBP, p < 0.01), and the smallest in summer (16 +/- 12 and 6 +/- 5 mmHg). Daily variations of SBP and DBPs in spring (19 +/- 12 and 7 +/- 6 mmHg) and fall (20 +/- 13 and 9 +/- 8 mmHg) were between those of summer and winter. Our results indicate that not only averaged blood pressure but also variations of blood pressure in winter are larger than the other seasons, and suggest that these blood pressure variations participate in cardiovascular events in hypertensive patients with end-stage renal diseases.
authors.affiliation: Saitama Medical University, Department of Nephrology, Iruma Saitama, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takenaka
authors.forename: Eriko
authors.initials: E
authors.lastname: Kojima
authors.forename: Keita
authors.initials: K
authors.lastname: Sueyoshi
authors.forename: Takahiko
authors.initials: T
authors.lastname: Sato
authors.forename: Kosuke
authors.initials: K
authors.lastname: Uchida
authors.forename: Jonde
authors.initials: J
authors.lastname: Arai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hoshi
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Kato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takane
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D000465:Algorithms; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D018570:Risk Assessment; D012621:Seasons
chemical_list: D000959:Antihypertensive Agents