title: Ambulatory blood pressure monitoring in patients with chronic kidney disease and resistant hypertension.
abstract: The role of ambulatory blood pressure (BP) monitoring (ABPM) has not been well-studied in patients with chronic kidney disease and resistant hypertension. In a retrospective study of the outpatient chronic kidney disease population, 156 patients with chronic kidney disease and resistant hypertension who had 24-hour ABPM and clinic BP measurements were identified. Resistant hypertension was defined as uncontrolled clinic BP while taking ≥ 3 medications including a diuretic or controlled BP while taking ≥ 4 medications. Within the study group, ambulatory BP <130/80 mm Hg was found in 35.9% of all patients. Only 6.4% had both ambulatory and clinic BP <130/80 mm Hg. Prevalence of white-coat hypertension, masked hypertension, and sustained hypertension were 29.5%, 5.8%, and 58.3%, respectively. Compared with patients with sustained hypertension, more patients in the white-coat hypertension group had low nocturnal average systolic BP (defined as nocturnal average systolic BP <100 mm Hg) (17.4% vs 0%) and low 24-hour average diastolic BP (defined as 24-hour average diastolic BP <60 mm Hg) (52.2% vs 22%, P<.01). ABPM provides more reliable assessment of BP in patients with chronic kidney disease and resistant hypertension.
authors.affiliation: Department of Internal Medicine, St Elizabeth Health Center, Youngstown, OH, USA. salmanshafi@email.com
authors.forename: Salman
authors.initials: S
authors.lastname: Shafi
authors.forename: Erdal
authors.initials: E
authors.lastname: Sarac
authors.forename: Huy
authors.initials: H
authors.lastname: Tran
mesh_terms: D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D059466:White Coat Hypertension / Q000175:diagnosis / Q000209:etiology*