title: Home systolic blood pressure on the morning of dialysis days has prognostic impact for hypertensive hemodialysis patients.
abstract: BACKGROUND
  Hypertension is a leading cause of cardiovascular (CV) disease in the general population. Although hypertension is very common in maintenance hemodialysis (HD) patients, adequate blood pressure (BP) values and measurement timing have not been defined.
  
  
  METHODS
  A total of 49 hypertensive HD patients were recruited. Average age was 63 ± 11 years, and duration of dialysis therapy was 6.2 ± 4.2 years. Dialysis unit BPs and various types of home BPs were separately measured, and which BPs were the most critical markers in evaluating the effect of hypertension on left ventricular hypertrophy and CV events was investigated.
  
  
  RESULTS
  Predialysis systolic BPs were not correlated with any home BPs. Left ventricular mass index (LVMI) had a significant positive correlation with home BPs, especially morning systolic BPs on HD days (P < 0.01) and non-HD days (P < 0.05), on univariate and multivariate analysis. In contrast, predialysis BPs did not correlate with LVMI. During the follow-up period (47 ± 18 months), it was demonstrated that diabetes and home BPs, especially systolic BPs on the morning of HD days, were significant predictors of CV events on multivariate Cox regression analysis. A 10 mmHg increase in BP had a significantly elevated relative risk for CV events.
  
  
  CONCLUSIONS
  Home BP, especially systolic BPs in the morning on HD days, can provide pivotal information for management of HD patients.
authors.affiliation: Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. mogura@jikei.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Ogura
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Terawaki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Hamaguchi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kimura
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Hosoya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers