title: Prognostic value of 48-hour ambulatory blood pressure measurement and cardiovascular mortality in hemodialysis patients.
abstract: BACKGROUND
  Hypertension is common and contributes to high cardiovascular morbidity and mortality in hemodialysis (HD) patients. It is unknown which blood pressure (BP) better defines the influence on cardiovascular mortality. The purpose of our study was to analyze the relationship between various BP measurements, traditional risk factors, markers of asymptomatic atherosclerosis [left ventricular mass (LVM), carotid intima media thickness (IMT)], and cardiovascular mortality in HD patients.
  
  
  METHODS
  Seventy-three patients (44 males and 29 females; mean age: 54.2 years) were included. BP was measured before and after HD and 48-hour ambulatory blood pressure monitoring (ABPM) was performed. Using sonography, the LVM index and carotid IMT were measured.
  
  
  RESULTS
  During a follow-up period up to 3,664 days, 28 patients died - 16 of them from cardiovascular causes. In a Cox regression model, which included age, gender, smoking, diabetes, sensitive C-reactive protein, albumin, hemoglobin, troponin T, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, calcium, phosphorus, carotid IMT, and LVM index, only 48-hour systolic ABPM (p = 0.037) and 48-hour diastolic ABPM (p = 0.006) turned out to be independent predictors of cardiovascular death.
  
  
  CONCLUSIONS
  Only 48-hour ABPM and not single BP measurements before or after HD were associated with cardiovascular mortality in HD patients.
authors.affiliation: Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia. robert.ekart2@guest.arnes.si
authors.forename: Robert
authors.initials: R
authors.lastname: Ekart
authors.forename: Vojko
authors.initials: V
authors.lastname: Kanič
authors.forename: Breda
authors.initials: B
authors.lastname: Pečovnik Balon
authors.forename: Sebastjan
authors.initials: S
authors.lastname: Bevc
authors.forename: Radovan
authors.initials: R
authors.lastname: Hojs
mesh_terms: D000328:Adult; D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000401:mortality*; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000401:mortality; D014463:Ultrasonography