title: Relationship of ambulatory blood pressure and the heart rate profile with renal function parameters in hypertensive patients with chronic kidney disease.
abstract: Strict blood pressure (BP) control is reportedly important for the management of hypertensive patients with chronic kidney disease (CKD). The purpose of this cross-sectional study was to examine whether the variables of ambulatory BP and the heart rate (HR) profile, central hemodynamics, and arterial stiffness were closely related to the renal function parameters (urine albumin excretion rate [UACR] and estimated glomerular filtration rate [eGFR]) observed in 25 consecutive hospitalized hypertensive patients with CKD. There were significant positive relationships between UACR and 24-hour, daytime, and nighttime ambulatory systolic BP. In addition, there were significant negative relationships between UACR and 24-hour and daytime HR variability. The circulating B-type natriuretic peptide level and hemoglobin A1c were also positively related to UACR. With respect to eGFR, although the 24-hour and nighttime HR variability were positively associated with eGFR, the circulating pentosidine and nighttime HR had a negative relationship with eGFR. On the other hand, central hemodynamics and arterial stiffness did not exhibit any significant association with renal function parameters. These results indicate that ambulatory BP and the HR profile are closely modulated by renal function deterioration. Further studies are needed to investigate the causal relationship between ambulatory BP and the HR profile and renal function parameters in hypertensive patients with CKD.
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Kanaoka
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamura
authors.forename: Masato
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Mai
authors.initials: M
authors.lastname: Yanagi
authors.forename: Sona
authors.initials: S
authors.lastname: Haku
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Wakui
authors.forename: Akinobu
authors.initials: A
authors.lastname: Maeda
authors.forename: Toru
authors.initials: T
authors.lastname: Dejima
authors.forename: Kengo
authors.initials: K
authors.lastname: Azushima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsuhashi
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Okano
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fujikawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Toya
authors.forename: Shunsaku
authors.initials: S
authors.lastname: Mizushima
authors.forename: Osamu
authors.initials: O
authors.lastname: Tochikubo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology; D055109:Ankle Brachial Index; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006339:Heart Rate; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*; D059289:Vascular Stiffness