title: Blood pressure profile in renal transplant recipients and its relation to diastolic function: tissue Doppler echocardiographic study.
abstract: Hypertension is a common complication after renal transplantation and is associated with increased risk of cardiovascular disease. The aim of the current study was to investigate the diurnal blood pressure pattern and its relation to structural and functional cardiac changes in renal transplant recipients. Sixty-six stable renal transplant patients (34 female, 32 male), aged 7 to 25 years (mean 17.4±4.3 years) were enrolled in this study. Cardiac function assessed by tissue Doppler echocardiography and blood pressure measurement performed using both the ambulatory and the casual method. Hypertension was demonstrated in 57% of recipients by the casual method and in 75.7% by ambulatory blood pressure monitoring (ABPM). The efficacy of BP control among patients on antihypertensive drugs was 60%. The prevalence of non-dipping was 73%. There was significant inverse correlation between systolic or diastolic day-time or night-time BP index and post-transplant duration (p<0.001, r=-0.386), but no correlation between ABP parameters and BMI, gender, and eGFR. There was a significant relationship between all ABP parameters and left ventricular mass index (LVMI) (p=0.025-0.007, r=0.28-0.38). LVMI was significantly higher in hypertensive than in normotensive cases (p=0.034). There was no difference in diastolic function between hypertensive and normotensive patients or between patients with and without left ventricular hypertrophy (LVH). In conclusion, our study showed the advantage of ABPM over the casual method of diagnosis of hypertension. LVH is common in transplant patients and is likely associated with arterial hypertension. Hypertension and LVH cannot differentiate transplant patients with diastolic malfunction.
authors.affiliation: Shiraz Nephrology Urology Research Center, Shiraz University of Medical Sciences, and Nemazee Hospital, Shiraz, Iran. m_basiratnia@yahoo.com
authors.forename: Mitra
authors.initials: M
authors.lastname: Basiratnia
authors.forename: Maryam
authors.initials: M
authors.lastname: Esteghamati
authors.forename: Gholam Hossein
authors.initials: GH
authors.lastname: Ajami
authors.forename: Hamid
authors.initials: H
authors.lastname: Amoozgar
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cheriki
authors.forename: Manoochehr
authors.initials: M
authors.lastname: Soltani
authors.forename: Ali
authors.initials: A
authors.lastname: Derakhshan
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Fallahzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001314:Auscultation; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D002940:Circadian Rhythm; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D007492:Iran; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D019722:Sphygmomanometers; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents